T2MR and T2Candida: novel technology for the rapid diagnosis of candidemia and invasive candidiasis

Pfaller, Michael A.; Wolk, Donna M.; Lowery, Thomas J.

doi:10.2217/fmb.15.111

Cited by 130 publications

(59 citation statements)

References 72 publications

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“…55 In their appraisal of clinical studies to date, Pfaller and colleagues noted that the T2Candida Panel also detected all 12 confirmed cases of deep-seated infections in patients with negative blood cultures, suggesting a potential role to diagnose previously unrecognized Candida infections. 56 Additional studies are certainly warranted to see if PCR, BDG, or T2Candida Panel can improve antifungal utilization and patient outcomes for IC, but their benefits may not be fully realized if there is absence of real-time AS intervention. 57 …”

Section: Improving Diagnosis Of Invasive Candidiasismentioning

confidence: 99%

Antifungal stewardship considerations for adults and pediatrics

2016

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Antifungal stewardship refers to coordinated interventions to monitor and direct the appropriate use of antifungal agents in order to achieve the best clinical outcomes and minimize selective pressure and adverse events. Antifungal utilization has steadily risen over time in concert with the increase in number of immunocompromised adults and children at risk for invasive fungal infections (IFI). Challenges in diagnosing IFI often lead to delays in treatment and poorer outcomes. There are also emerging data linking prior antifungal exposure and suboptimal dosing to the emergence of antifungal resistance, particularly for Candida. Antimicrobial stewardship programs can take a multi-pronged bundle approach to ensure suitable prescribing of antifungals via postprescription review and feedback and/or prior authorization. Institutional guidelines can also be developed to guide diagnostic testing in at-risk populations; appropriate choice, dose, and duration of antifungal agent; therapeutic drug monitoring; and opportunities for de-escalation and intravenous-to-oral conversion.

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Section: Improving Diagnosis Of Invasive Candidiasismentioning

confidence: 99%

Antifungal stewardship considerations for adults and pediatrics

2016

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“…To this regard, a novel technology, based on the application of T2 magnetic resonance (T2MR), was exploited to develop an automated instrument platform, T2Dx, which provides a 'patient sample-to-answer' clinical diagnostic test, namely the T2Candida (Pfaller et al 2015). In this FDA-cleared test, whole blood is subjected to PCR amplification of Candida sequences, followed by hybridization to nanoparticles that elicit a T2MR signal to detect Candida species-this without the need for culture or nucleic acid extraction steps.…”

Section: Nonculture Based Diagnosticsmentioning

confidence: 99%

Diagnostic of Fungal Infections Related to Biofilms

Sanguinetti

Posteraro

2016

Advances in Experimental Medicine and Biology

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Fungal biofilm-related infections, most notably those caused by the Candida and Aspergillus genera, need to be diagnosed accurately and rapidly to avoid often unfavorable outcomes. Despite diagnosis of these infections is still based on the traditional histopathology and culture, the use of newer, rapid methods has enormously enhanced the diagnostic capability of a modern clinical mycology laboratory. Thus, while accurate specieslevel identification of fungal isolates can be achieved with turnaround times considerably shortened, nucleic acid-based or antigen-based detection methods can be considered useful adjuncts for the diagnosis of invasive forms of candidiasis and aspergillosis. Furthermore, simple, reproducible, and fast methods have been developed to quantify biofilm production by fungal isolates in vitro. In this end, isolates can be categorized as low, moderate, or high biofilm-forming, and this categorization may reflect their differential response to the conventional antifungal therapy. By means of drug susceptibility testing performed on fungal biofilm-growing isolates, it is now possible to evaluate not only the activity of conventional antifungal agents, but also of novel anti-biofilm agents. Despite this, future diagnostic methods need to target specific biofilm components/molecules, in order to provide a direct proof of the presence of this growth phenotype on the site of infection. In the meantime, our knowledge of the processes underlying the adaptive drug resistance within the biofilm has put into evidence biofilm-specific molecules that could be potentially helpful as therapeutic targets. Surely, the successful management of clinically relevant fungal biofilms will rely upon the advancement and/or refinement of these approaches.

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“…Five hours later, results are displayed on a touchscreen interface. The gemisch is neutralized with a bleach solution, popping out the back of the machine for disposal (2 ). "It's like an Easy Bake Oven for sepsis diagnosis," says Lowery.…”

Section: How Does It Work?mentioning

confidence: 99%

“…Because it's a brand new technology, hospitals will take time to evaluate it not only as a mortality reducer, but also its cost efficiency. A recent analysis published in Future Microbiology indicates that the tests saves $1148 per tested patient, and that there's a 60% mortality savings (2 ). "This assay does provide significant and clinically relevant information," says Dr. Mylonakis.…”

Section: How Does It Work?mentioning

confidence: 99%