International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Serial T2Bacteria panel versus blood culture for monitoring Staphylococcus aureus bacteraemia: clearance duration predicts deep-seated or metastatic infection and mortality.
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Traugott Marianna, Mahmoudi Mahdi, Groza Cristina, Breinbauer Klaus, Kirschner Harald, Oelschlaegel Theresa, Stuecklschwaiger David, Naegeli Michelle, Augustin Max, Totschnig David, Bumberger Armin Marcus, Wenisch Christoph, Zoufaly Alexander, Clodi-Seitz Tamara
Аннотация
OBJECTIVE: This study evaluates the clearance duration of the rapid molecular diagnostic T2Bacteria®Panel (T2B) in S. aureus bacteraemia and its prognostic utility for predicting deep-seated or metastatic infection or mortality relative to blood culture.
PATIENTS AND METHODS: In 56 hospitalized adults with S. aureus bacteraemia at a tertiary-care hospital, blood cultures and T2B tests were collected every 48 hours until both methods showed negative results. Clearance duration was defined from the first positive study BC to the day of the last documented positive blood culture or T2B result; prolonged bacteraemia was defined as a last positive test result >3 days after study inclusion. The primary infection-related endpoint was deep-seated or metastatic infection. The combined prognostic endpoint was deep-seated or metastatic infection and/or in-hospital mortality.
RESULTS: T2B detected S. aureus significantly longer than blood culture (mean last positive day 3.9 days (SD 4.8) vs 1.7 days (SD 1.2)). Prolonged clearance measured by T2B was significantly associated with deep-seated or metastatic infection compared to short T2B clearance (57.1% [12/21] vs 8.6% [3/35]; P<0.001) and increased in-hospital mortality (42.9% [9/21] vs 14.3% [5/35]; P=0.038). Clearance duration measured by T2B showed significantly better predictive performance than blood culture clearance duration for predicting deep-seated or metastatic infection (AUC = 0.798 vs 0.647, bootstrap P=0.042). AUC differences for mortality were not statistically significant.
CONCLUSION: Prolonged T2B positivity identifies patients at increased risk for deep-seated or metastatic infection and is superior to blood culture clearance duration for predicting these complications in S. aureus bacteraemia. These findings suggest that serial T2B testing may help identify patients who warrant intensified diagnostic evaluation for persistent infectious foci.
PATIENTS AND METHODS: In 56 hospitalized adults with S. aureus bacteraemia at a tertiary-care hospital, blood cultures and T2B tests were collected every 48 hours until both methods showed negative results. Clearance duration was defined from the first positive study BC to the day of the last documented positive blood culture or T2B result; prolonged bacteraemia was defined as a last positive test result >3 days after study inclusion. The primary infection-related endpoint was deep-seated or metastatic infection. The combined prognostic endpoint was deep-seated or metastatic infection and/or in-hospital mortality.
RESULTS: T2B detected S. aureus significantly longer than blood culture (mean last positive day 3.9 days (SD 4.8) vs 1.7 days (SD 1.2)). Prolonged clearance measured by T2B was significantly associated with deep-seated or metastatic infection compared to short T2B clearance (57.1% [12/21] vs 8.6% [3/35]; P<0.001) and increased in-hospital mortality (42.9% [9/21] vs 14.3% [5/35]; P=0.038). Clearance duration measured by T2B showed significantly better predictive performance than blood culture clearance duration for predicting deep-seated or metastatic infection (AUC = 0.798 vs 0.647, bootstrap P=0.042). AUC differences for mortality were not statistically significant.
CONCLUSION: Prolonged T2B positivity identifies patients at increased risk for deep-seated or metastatic infection and is superior to blood culture clearance duration for predicting these complications in S. aureus bacteraemia. These findings suggest that serial T2B testing may help identify patients who warrant intensified diagnostic evaluation for persistent infectious foci.