Microbial Volatiles as Diagnostic Biomarkers of Bacterial Lung Infection in Mechanically Ventilated Patients
Issued Date
2023-03-15
Resource Type
ISSN
10584838
eISSN
15376591
Scopus ID
2-s2.0-85157986950
Pubmed ID
36310531
Journal Title
Clinical Infectious Diseases
Volume
76
Issue
6
Start Page
1059
End Page
1066
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Infectious Diseases Vol.76 No.6 (2023) , 1059-1066
Suggested Citation
Ahmed W.M., Fenn D., White I.R., Dixon B., Nijsen T.M.E., Knobel H.H., Brinkman P., Van Oort P.M.P., Schultz M.J., Dark P., Goodacre R., Felton T., Bos L.D.J., Fowler S.J., Ahmed W.M., Raventos A.A., Bannard-Smith J., Bos L.D.J., Camprubi M., Coelho L., Davie A., Diaz E., Goma G., Felton T., Fowler S.J., Goodacre R., Johnson C., Knobel H.H., Lawal O., Leopold J.H., Martin-Loeches I., Nijsen T.M.E., Van Oort P.M.P., Povoa P., Rattray N.J.W., Rijnders G., Schultz M.J., Steenwelle R., Sterk P.J., Valles J., Verhoeckx F., Vink A., Weda H., Winters T., Zakharkina T. Microbial Volatiles as Diagnostic Biomarkers of Bacterial Lung Infection in Mechanically Ventilated Patients. Clinical Infectious Diseases Vol.76 No.6 (2023) , 1059-1066. 1066. doi:10.1093/cid/ciac859 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87709
Title
Microbial Volatiles as Diagnostic Biomarkers of Bacterial Lung Infection in Mechanically Ventilated Patients
Author(s)
Ahmed W.M.
Fenn D.
White I.R.
Dixon B.
Nijsen T.M.E.
Knobel H.H.
Brinkman P.
Van Oort P.M.P.
Schultz M.J.
Dark P.
Goodacre R.
Felton T.
Bos L.D.J.
Fowler S.J.
Ahmed W.M.
Raventos A.A.
Bannard-Smith J.
Bos L.D.J.
Camprubi M.
Coelho L.
Davie A.
Diaz E.
Goma G.
Felton T.
Fowler S.J.
Goodacre R.
Johnson C.
Knobel H.H.
Lawal O.
Leopold J.H.
Martin-Loeches I.
Nijsen T.M.E.
Van Oort P.M.P.
Povoa P.
Rattray N.J.W.
Rijnders G.
Schultz M.J.
Steenwelle R.
Sterk P.J.
Valles J.
Verhoeckx F.
Vink A.
Weda H.
Winters T.
Zakharkina T.
Fenn D.
White I.R.
Dixon B.
Nijsen T.M.E.
Knobel H.H.
Brinkman P.
Van Oort P.M.P.
Schultz M.J.
Dark P.
Goodacre R.
Felton T.
Bos L.D.J.
Fowler S.J.
Ahmed W.M.
Raventos A.A.
Bannard-Smith J.
Bos L.D.J.
Camprubi M.
Coelho L.
Davie A.
Diaz E.
Goma G.
Felton T.
Fowler S.J.
Goodacre R.
Johnson C.
Knobel H.H.
Lawal O.
Leopold J.H.
Martin-Loeches I.
Nijsen T.M.E.
Van Oort P.M.P.
Povoa P.
Rattray N.J.W.
Rijnders G.
Schultz M.J.
Steenwelle R.
Sterk P.J.
Valles J.
Verhoeckx F.
Vink A.
Weda H.
Winters T.
Zakharkina T.
Author's Affiliation
Mahidol Oxford Tropical Medicine Research Unit
Faculty of Biology, Medicine and Health
Hamilton Medical AG
University of Nova Gorica
University of Liverpool
Philips Research
Salford Royal NHS Foundation Trust
Universiteit van Amsterdam
Amsterdam UMC - University of Amsterdam
Location VU Medical Center
Eurofins Materials Science Netherlands BV
Faculty of Biology, Medicine and Health
Hamilton Medical AG
University of Nova Gorica
University of Liverpool
Philips Research
Salford Royal NHS Foundation Trust
Universiteit van Amsterdam
Amsterdam UMC - University of Amsterdam
Location VU Medical Center
Eurofins Materials Science Netherlands BV
Other Contributor(s)
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.