The Role of T2 Candida in the Early Detection of Invasive Candidiasis Among Solid Organ Transplant Patients

Document Type

Conference Proceeding

Publication Date

1-11-2026

Publication Title

Open Forum Infect Dis

Keywords

adult, all cause mortality, antifungal activity, antifungal therapy, conference abstract, diagnosis, female, graft recipient, hospital readmission, hospitalization, human, invasive candidiasis, male, rapid test, retrospective study, systemic mycosis, therapy

Abstract

Background: Invasive Candidiasis (IC) is the leading cause of invasive fungal infections in solid organ transplant recipients (SOTr). T2Candida is a rapid diagnostic test that can improve antifungal use in SOTr. We describe the clinical characteristics and outcomes of SOTr who underwent T2Candida testing (T2) for suspected IC at our institution. Methods: A retrospective study including adult SOTr who underwent T2 for suspected IC between 01/2015-12/2024. We compared data of patients with positive T2 alone (T2pos-alone) vs. positive T2/positive culture from sterile site (T2pos-IC), and patients with negative T2 (T2neg-alone) vs. negative T2/positive culture (T2neg-IC). Results: From the 305 SOTr included, 43 (14%) had a positive T2. Baseline characteristics were comparable between groups (Table 1). Median time from transplant to suspected/confirmed IC was 284 [33-2659] days. Transplanted organs included liver (36%), kidney (22%), and lung (17%) (Fig 1). In SOTr with positive T2, 13 (30%) had concomitant isolation of Candida spp. in cultures (T2pos-IC) (Fig 2). Median duration of hospitalization and antifungal therapy (AFT) was significantly shorter in the T2pos-alone group vs. T2pos-IC (19 vs. 49 days, p=0.03, 14 vs. 19 days, p=0.04, respectively). 90-day all-cause mortality was highest in T2pos-IC (Table 2). In SOTr with negative T2, 248 (95%) did not have concomitant isolation of Candida spp. in cultures (T2neg-alone). Based on T2 results, 64 (24%) SOTr stopped AFT in ≤48hrs and 145 (55%) did not receive any AFT. Median duration of AFT, IC-related 90-day mortality, and readmission due to relapsed infection were significantly lower in the T2neg-alone group compared to T2Neg-IC (2 vs. 25 days, p< 0.01, 1% vs 14% p=0.02, 0 vs 14% p< 0.01, respectively) (Table 2). Conclusion: SOTr with T2pos-IC had higher mortality and significantly higher duration of hospitalization and AFT compared to T2pos-alone. A negative T2 frequently prompted discontinuation or avoidance of AFT. Patients with T2neg-alone had low mortality and no readmission for suspected IC. Further studies are needed to evaluate the role of rapid diagnostics in the SOTr population.

Volume

13

First Page

S1079

Last Page

S1080

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