T2Bacteria panel rapidly and accurately diagnoses common bloodstream infections

1. T2Bacteria panel rapidly and accurately diagnoses common bloodstream infections

More research suggested to determine effect on clinical practice

Editorial: http://annals.org/aim/article/doi/10.7326/M19-0971

Abstract: http://annals.org/aim/article/doi/10.7326/M18-2772

URLs go live when the embargo lifts

In a clinical trial, the T2Bacteria Panel showed promise for rapidly and accurately diagnosing bloodstream infections or sepsis caused by five common bacteria. The test could be used in a clinical setting in place of blood cultures, which are insensitive and can take a long time to show results. How these findings will affect clinical practice is not yet determined. Findings from a diagnostic accuracy study are published in Annals of Internal Medicine.

In 2018, the T2Bacteria Panel was cleared by the FDA to identify sepsis-causing bacteria directly from whole blood without the wait for blood culture, which currently takes 1 to 5 or more days and is the current standard of care for diagnosing bloodstream infections. The T2Bacteria Panel can deliver results in 3 to 5 hours for the most common ESKAPE bacteria, or Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli.

Researchers from the University of Pittsburgh School of Medicine studied 1,427 patients at 11 U.S. hospitals for whom blood cultures were ordered to assess performance of the T2Bacteria Panel in diagnosing suspected bloodstream infections. The researchers compared blood culture results to those obtained using the T2Bacteria Panel. The T2Bacteria Panel accurately identified or excluded bloodstream infections caused by five common ESKAPE pathogens in about 4 to 8 hours versus about 24 to 72 hours and 5 days, respectively, for blood cultures. According to the researchers, these findings suggest that using the T2Bacteria Panel could shorten the time to appropriate antibiotic treatment in patients, which has the potential to improve clinical outcomes.

The authors of an accompanying editorial from Atrium Health - Carolinas Medical Center caution that the clinical benefit of the T2Bacteria Panel is still uncertain. Outcomes studies are needed to determine if use of the T2Bacteria Panel can lead to better outcomes, such as significantly shorter time to appropriate therapy. Other factors, such potential overuse of antibiotics, cost, and laboratory time must also be considered.

Notes and media contacts: For an embargoed PDF, please contact Lauren Evans at laevans@acponline.org. To speak with the lead author, M. Hong Nguyen, MD, please contact mhn5@pitt.edu.

2. Low back pain is prevalent among workers and may be underreported

Abstract: http://annals.org/aim/article/doi/10.7326/M18-3602

URLs go live when the embargo lifts

Low back pain affects more than a quarter of working adults, often affecting their ability to work. However, these estimates may be underreported. Survey findings are published in Annals of Internal Medicine.

There are few estimates available in the U.S. of the proportion of back pain that is related to work. In 2015, the NHIS (National Health Interview Survey) collected supplemental data about the work-relatedness and the effects on work of back pain--specifically, low back pain -- among U.S. workers for the first time in nearly 3 decades.

Researchers randomly surveyed more than 19,000 adults to estimate the burden of low back pain among U.S. workers and whether the pain was related to work and/or had an effect on work. They found that the 3-month prevalence of any low back pain among U.S. workers was approximately 26.4 percent, representing almost 40 million workers. Many of these cases were attributed to work by a health care professional, but most workers affected did not discuss work-relatedness with their providers. They also found that low back pain had affected many current workers' ability to work. According to the researchers, these findings may greatly underestimate the total occupational effect of low back pain in the population because of the short recall period and exclusion of former workers, some of whom may have left the workforce because of work-related low back pain.

Notes and media contacts: For an embargoed PDF, please contact Lauren Evans at laevans@acponline.org. The lead author, Sara Luckhaupt, please contact Marie Sweeney at mhs2@cdc.gov.

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Also New in this issue:

Cases in Precision Medicine: Genetic Assessment After a Sudden Cardiac Death in the Family

Ronald Laracuente, BA; Marc Paul Waase, MD; Isha Kalia, MS; Arthur A.M. Wilde, MD; and Wendy K. Chung, MD, PhD

Precision Medicine

Abstract: http://annals.org/aim/article/doi/10.7326/M18-2359