Sepsis Diagnosis in the Intensive Care Unit: A Comparative Study of Rapid Molecular Diagnostics and Conventional Blood Cultures

<b>Background:</b> Sepsis remains a leading cause of morbidity and mortality worldwide, where timely and accurate pathogen detection is critical for improved outcomes. Conventional blood cultures are the gold standard but are limited by prolonged turnaround times and suboptimal sensitivity, often delaying targeted therapy. <b>Methods:</b> This single-center retrospective study evaluated the diagnostic performance and clinical utility of the T2Bacteria and T2Resistance Panels compared with conventional blood cultures in 30 adult patients admitted to the cardiovascular intensive care unit with a suspected bloodstream infection. <b>Results:</b> The T2Bacteria Panel demonstrated high diagnostic accuracy for on-panel organisms (100%), detecting all cases of <i>Klebsiella pneumoniae</i>, <i>Acinetobacter baumannii</i>, and <i>Pseudomonas aeruginosa,</i> while blood cultures detected 9 of 12 on-panel infections. In contrast, two off-panel organisms were isolated from five patients exclusively by blood cultures, highlighting the complementary roles of both methods. Importantly, antimicrobial therapy was modified in 6 of 10 T2-positive patients (60%) based on T2 results, preceding blood culture reporting by a median of more than 100 h. <b>Conclusions:</b> These findings underscore the value of T2 assays in enabling earlier, evidence-based therapeutic decisions and supporting antimicrobial stewardship. While limited by the sample size and single-center design, these findings-consistent with pathogen distributions reported in European ICU settings-suggest that integrating T2-based diagnostics into cardiovascular ICU workflows may enhance early therapeutic decision-making and antimicrobial stewardship.