Microbial Volatiles as Diagnostic Biomarkers of Bacterial Lung Infection in Mechanically Ventilated Patients
Year: 2022
Type: article
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 noninvasive 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 mechanical ventilation from the BreathDx study. Samples were analyzed by thermal desorption-gas chromatography-mass spectrometry. RESULTS: Pathogens from bronchoalveolar lavage (BAL) cultures were identified in 45 of 89 patients and Staphylococcus aureus was the most commonly identified pathogen (n = 15). Of 19 mVOCs detected in the in vitro culture headspace of 4 common respiratory pathogens (S. aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli), 14 were found in exhaled breath samples. Higher concentrations of 2 mVOCs were found in the exhaled breath of patients infected with S. aureus compared to those without (3-methylbutanal: P < .01, area under the receiver operating characteristic curve [AUROC] = 0.81-0.87; and 3-methylbutanoic acid: P = .01, AUROC = 0.79-0.80). In addition, bacteria identified from BAL cultures that are known to metabolize tryptophan (E. coli, Klebsiella oxytoca, and Haemophilus influenzae) were grouped and found to produce higher concentrations of indole compared to breath samples with culture-negative (P = .034) and other pathogen-positive (P = .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 multicenter clinical studies.
Source: Clinical Infectious Diseases
DOI: 10.1093/cid/ciac859
Authors: Waqar M Ahmed, Dominic Fenn, Iain R White, Breanna Dixon, Tamara M E Nijsen, Hugo H Knobel, Paul Brinkman, Pouline M P Van Oort, Marcus J Schultz, Paul Dark, Royston Goodacre, Timothy Felton, Lieuwe D J Bos, Stephen J Fowler, Waqar M Ahmed, Antonio Artigas Raventos, Jonathan Bannard-Smith, Lieuwe D J Bos, Marta Camprubi, Luis Coelho, Paul Dark, Alan Davie, Emili Diaz, Gemma Goma, Timothy Felton, Stephen J Fowler, Royston Goodacre, Craig Johnson, Hugo Knobel, Oluwasola Lawal, Jan-Hendrik Leopold, Ignacio Martin-Loeches, Tamara M E Nijsen, Pouline M P van Oort, Pedro Povoa, Nicholas J W Rattray, Guus Rijnders, Marcus J Schultz, Ruud Steenwelle, Peter J Sterk, Jordi Valles, Fred Verhoeckx, Anton Vink, Hans Weda, Iain R White, Tineke Winters, Tetyana Zakharkina
Institutions: Manchester Academic Health Science Centre, University of Manchester, Manchester University NHS Foundation Trust, Amsterdam UMC Location University of Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, University of Nova Gorica, Philips (Netherlands), Eurofins (Netherlands), Amsterdam UMC Location Vrije Universiteit Amsterdam, Mahidol University, Hamilton Medical (Switzerland), Mahidol Oxford Tropical Medicine Research Unit, Salford Royal NHS Foundation Trust, University of Liverpool
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: hybrid
Estimated APC paid: $4,320
Funders: Pfizer, AstraZeneca, National Institute for Health and Care Research, Javna Agencija za Raziskovalno Dejavnost RS, Stichting Astma Bestrijding, Swedish Orphan Biovitrum, Directorate for Biological Sciences, Manchester Biomedical Research Centre, HORIZON EUROPE Framework Programme, Biotechnology and Biological Sciences Research Council, FP7 People: Marie-Curie Actions, Eurostars, Manchester Clinical Research Facility
OpenAlex ID: W4307771069