Title: | Microbial volatiles as diagnostic biomarkers of bacterial lung infection in mechanically ventilated patients |
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Authors: | ID Ahmed, Waqar M, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK (Author) ID Fenn, Dominic, Department of respiratory medicine, Amsterdam UMC location AMC, University of Amsterdam, Amsterdam, the Netherlands (Author) ID White, Iain R., Laboratory for Environmental and Life Science, University of Nova Gorica, Nova Gorica, Slovenia (Author) ID Dixon, Breanna, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK (Author) ID Nijsen, Tamara M E, Philips Research, Philips B.V., Eindhoven, the Netherlands (Author) ID Knobel, Hugo H, Eurofins Materials Science Netherlands BV, High Tech Campus, Eindhoven, the Netherlands (Author) ID Brinkman, Paul, Department of respiratory medicine, Amsterdam UMC location AMC, University of Amsterdam, Amsterdam, the Netherlands (Author) ID van Oort, Pouline M P, Department of Anaesthesiology, Amsterdam UMC location VUmc, Amsterdam, the Netherlands (Author) ID Schultz, Marcus J, Intensive Care, Amsterdam UMC location AMC, Amsterdam, the Netherlands (Author) ID Dark, Paul, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK (Author) ID Goodacre, Royston, Centre for Metabolomics Research, Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK (Author) ID Felton, Timothy, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK (Author) ID Bos, Lieuwe D J, Department of respiratory medicine, Amsterdam UMC location AMC, University of Amsterdam, Amsterdam, the Netherlands (Author) ID Fowler, Stephen J., Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK (Author) |
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Language: | English |
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Work type: | Not categorized |
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Typology: | 1.01 - Original Scientific Article |
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Organization: | UNG - University of Nova Gorica
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Abstract: | Background
Early and accurate recognition of respiratory pathogens is crucial to prevent increased risk of mortality in critically ill patients. Microbial-derived volatile organic compounds (mVOCs) in exhaled breath could be used as non-invasive biomarkers of infection to support clinical diagnosis.
Methods
In this study, we investigated the diagnostic potential of in vitro confirmed mVOCs in the exhaled breath of patients under mechanically ventilation from the BreathDx study. Samples were analysed by thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS).
Results
Pathogens from bronchoalveolar lavage (BAL) cultures were identified in 45/89 patients and S. aureus was the most commonly identified pathogen (n = 15). Out of 19 mVOCs detected in the in vitro culture headspace of four common respiratory pathogens (Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli), 14 were found in exhaled breath samples. Higher concentrations of two mVOCs were found in the exhaled breath of patients infected with S. aureus compared to those without (3-methylbutanal p < 0.01. AUROC = 0.81-0.87 and 3-methylbutanoic acid p = 0.01. AUROC = 0.79-0.80). In addition, bacteria identified from BAL cultures which are known to metabolise tryptophan (Escherichia coli, Klebsiella oxytoca and Haemophilus influenzae) were grouped and found to produce higher concentrations of indole compared to breath samples with culture-negative (p = 0.034) and other pathogen-positive (p = 0.049) samples.
Conclusions
This study demonstrates the capability of using mVOCs to detect the presence of specific pathogen groups with potential to support clinical diagnosis. Although not all mVOCs were found in patient samples within this small pilot study, further targeted and qualitative investigation is warranted using multi-centre clinical studies. |
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Keywords: | Breath, VOCs, infection, respiratory pathogens, VAP |
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Publication version: | Author Accepted Manuscript |
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Year of publishing: | 2022 |
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Number of pages: | 23 |
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Numbering: | ciac859 |
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PID: | 20.500.12556/RUNG-7758 |
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COBISS.SI-ID: | 130984195 |
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DOI: | 10.1093/cid/ciac859 |
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NUK URN: | URN:SI:UNG:REP:ZWUI9CG4 |
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Publication date in RUNG: | 28.11.2022 |
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Views: | 2213 |
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Downloads: | 0 |
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