T2Candida magnetic resonance in patients with invasive candidiasis: Strengths and limitations.
T2Candida magnetic resonance in patients with invasive candidiasis: Strengths and limitations.
复制标题
T2念珠菌磁共振在侵袭性念珠菌病患者中的应用：优点和局限性。
作者：
Christoph J. Zurl;J. Prattes;I. Zollner;T. Valentin;J. Rabensteiner;Stefanie Wunsch;M. Hoenigl;R. Krause
T2 Candida可在约5小时内检测全血中的5种念珠菌。前瞻性地储存了经EDTA抽取的血液样本，并在通过常规指标血液或无菌部位培养鉴定的侵袭性念珠菌病患者中进行了T2念珠菌检测。将T2念珠菌与诊断性血液和无菌部位培养物进行比较，并与索引培养物采集前后获得的样本进行比较。对32例念珠菌血症患者和22例深部侵袭性念珠菌病患者的133份样本进行了T2念珠菌检测。在念珠菌病组中，28/32（87.5%）例患者在任何时间点至少有一个阳性T2念珠菌结果。总共有17/25（68%）例念珠菌病患者的T2念珠菌样本阳性，与索引血培养同时采集。在每例患者分析中，17/18例（94.4%）在任何时间点具有匹配的T2念珠菌样本和外周血培养物的念珠菌病患者的T2念珠菌检测结果为阳性。T2念珠菌显示不一致的念珠菌菌种鉴定在两个念珠菌病患者。6/22例（27.3%）深部IC患者T2念珠菌检测结果阳性。尽管获得结果的时间较早，但T2念珠菌在诊断念珠菌血症方面的临床价值似乎受到缺少血培养阳性病例的限制。T2念珠菌阳性率增加时，系列T2念珠菌样本进行了测试。在疑似深部侵袭性念珠菌病的患者中，T2念珠菌可能作为无菌部位培养的血液辅助物。
T2Candida enables detection of five Candida species in whole blood within approximately 5 hours. Routinely drawn EDTA blood samples were prospectively stored and tested with T2Candida in patients with invasive candidiasis identified by routine index blood or sterile site cultures. T2Candida was compared to diagnostic blood and sterile site cultures and also performed with samples obtained prior and after collection of index cultures. T2Candida was evaluated with 133 samples of 32 patients with candidemia and 22 patients with deep-seated invasive candidiasis. In the candidemic group 28/32 (87.5%) patients had at least one positive T2Candida result at any time point. A total of 17/25 (68%) candidemic patients had a positive T2Candida sample that was drawn concurrently to the index blood culture. In the per patient analysis 17/18 (94.4%) candidemic patients with matched T2Candida samples and peripheral blood cultures at any timepoint had a positive T2Candida test. T2Candida revealed discordant Candida species identification in two candidemic patients. Six of 22 (27.3%) deep-seated IC patients had a positive T2Candida result. Despite advanced time-to-results the clinical value of T2Candida in diagnosing candidemia seems to be limited by missing blood culture positive cases. Positivity rates of T2Candida increased when serial T2Candida samples were tested. In patients with suspected deep-seated invasive candidiasis T2Candida might act as a blood based adjunct to sterile site cultures.