The Detection of Wound Infection by Ion Mobility Chemical Analysis

Volatile organic compounds (VOCs) detection for the identification of bacterial infections in clinical wound samples

Early detection of wound infections is critical for timely intervention and prevention of possible complications since prompt treatment can help lower pathogen spread and enhance faster healing. Early detection also helps reduce the risk of serious infections requiring extensive medical interventions or life-threatening diseases such as sepsis. Culture-based approaches currently used for bacterial identification have limited sensitivity and specificity. At the same time, they are time-consuming, resulting in delays in therapy and, therefore, having a negative impact on the treatment outcomes. Quantifying the volatile organic compounds (VOCs) released by bacteria residing in wounds is a promising, non-invasive option for detecting infections at early stages. This method allows for continuous monitoring without requiring invasive procedures, thereby reducing patient discomfort and the risk of further complications. Spectroscopy methods and sensors are the primary VOC detection and quantification approaches, but sensors are more rapid, cost-effective, non-invasive, and precise. This review highlights the significance of the early detection of wound infection to enable timely intervention and prevent complications, emphasizing the limitations of culture-based approaches. It also explores the potential of quantifying VOCs using different methods and discusses the correlation between their levels and the rate of bacterial infections in wounds. Additionally, the review evaluates current VOC-based monitoring methods for wound management, identifies gaps in the field, and advocates for further research to advance wound care and enhance patient outcomes.

Impact of malodour on health-related quality of life of patients with chronic wounds due to volatile organic compounds

Chronic wounds significantly impact health-related quality of life (HRQoL). Unpleasant wound odour, caused by bacterial colonisation and necrotic processes, is a distressing symptom. Its exact composition is not well understood, but it could be the basis for a personalised odour avoidance strategy. Therefore, this feasibility study explored 92 wounds from 66 patients with the focus on wound odour, bacterial burden and their impact on health related-quality of life (HRQoL). Volatile organic compounds (VOCs) responsible for wound odours were detected at the molecular level, using gas chromatography-mass spectrometry and -ion mobility spectrometry and correlated to the HRQoL. In patients analysed (average age 69 ± 13 years, wound persistence 24.31 ± 70.8 months) 135 pathogens were identified by swabbing including 19% Staphylococcus aureus, 15% Pseudomonas aeruginosa and 35% Enterobacteria. The specific questionnaire 'Wound-QoL-14' showed a non-significant difference in HRQoL in patients with wound odour (2.1 ± 1.0 vs. 1.8 ± 1.0). The latter also had the highest number of VOC detections. The most frequently detected, relevant VOCs from prokaryotic sources were dimethyl-disulphide and diacetyl-(2,3-butanedione). Furthermore, potential biomarkers for specific pathogens were identified, including dimethyl-trisulphide for P. aeruginosa and indole for Escherichia coli. The most prevalent substance groups were ketones and alcohols. In conclusion, the malodour of chronic wounds is caused by a mixture of the intrinsic odour of bacterial products and necrosis. This exploratory study, which combines the analysis of decoded VOCs and the olfactory assessment of odour, could be a novel, targeted approach for identifying potential 'anti-wound odour therapies' that will significantly benefit the HRQoL of patients with malodourous tumour wounds, in particular.

Advances in Wearable Biosensors for Wound Healing and Infection Monitoring

Wound healing is a complicated biological process that is important for restoring tissue integrity and function after injury. Infection, usually due to bacterial colonization, significantly complicates this process by hindering the course of healing and enhancing the chances of systemic complications. Recent advances in wearable biosensors have transformed wound care by making real-time monitoring of biomarkers such as pH, temperature, moisture, and infection-related metabolites like trimethylamine and uric acid. This review focuses on recent advances in biosensor technologies designed for wound management. Novel sensor architectures, such as flexible and stretchable electronics, colorimetric patches, and electrochemical platforms, enable the non-invasive detection of changes associated with wounds with high specificity and sensitivity. These are increasingly combined with AI and analytics based on smartphones that can enable timely and personalized interventions. Examples are the PETAL patch sensor that applies multiple sensing mechanisms for wide-ranging views on wound status and closed-loop systems that connect biosensors to therapeutic devices to automate infection control. Additionally, self-powered biosensors that tap into body heat or energy from the biofluids themselves avoid any external batteries and are thus more effective in field use or with limited resources. Internet of Things connectivity allows further support for remote sharing and monitoring of data, thus supporting telemedicine applications. Although wearable biosensors have developed relatively rapidly and their prospects continue to expand, regular clinical application is stalled by significant challenges such as regulatory, cost, patient compliance, and technical problems related to sensor accuracy, biofouling, and power, among others, that need to be addressed by innovative solutions. The goal of this review is to synthesize current trends, challenges, and future directions in wound healing and infection monitoring, with emphasis on the potential for wearable biosensors to improve patient outcomes and reduce healthcare burdens. These innovations are leading the way toward next-generation wound care by bridging advanced materials science, biotechnology, and digital health.

Gas chromatography-ion mobility spectrometry for the detection of human disease: a review

Gas chromatography-ion mobility spectrometry (GC-IMS) is an advanced technique used for detecting trace compounds, due to its non-destructive, straightforward, and rapid analytical capabilities. However, the application of GC-IMS in human disease screening is barely reported. This review summarizes the application and related parameters of GC-IMS in human disease diagnosis. GC-IMS detects volatile organic compounds in human breath, feces, urine, bile, etc. It can be applied to diagnose diseases, such as respiratory diseases, cancer, enteropathy, Alzheimer's disease, bacterial infection, and metabolic diseases. Several potential disease markers have been identified by GC-IMS, including ethanal (COVID-19), 2-heptanone (lung cancer) and 3-pentanone (pulmonary cryptococcosis). In conclusion, GC-IMS offers a non-invasive approach to monitor and diagnose human diseases with broad applications.

Analysis of Volatile Aroma Components in Different Parts of Shiitake Mushroom (Lentinus edodes) Treated with Ultraviolet C Light-Emitting Diodes Based on Gas Chromatography-Ion Mobility Spectroscopy

Further assessment of ultraviolet C light-emitting diode (UVC-LED) irradiation for influencing shiitake mushrooms' (Lentinus edodes) volatile and sensory properties is needed. In this study, a comparison of UVC-LED irradiation treatment on the flavor profiles in various parts of shiitake mushrooms was conducted using gas chromatography-ion mobility spectrometry (GC-IMS) and sensory analysis. Sixty-three volatile compounds were identified in shiitake mushrooms. The fresh shiitake mushrooms were characterized by the highest values of raw mushroom odors. After UVC-LED treatment, the content of C8 alcohols decreased, especially that of 1-octen-3-ol, while the content of aldehydes increased, especially the content of nonanal and decanal. The score of fatty and green odors was enhanced. For fresh samples, the mushroom odors decreased and the mushroom-like odors weakened more sharply when treated in ethanol suspension than when treated with direct irradiation. The fruit odors were enhanced using direct UVC-LED irradiation for fresh mushroom samples and the onion flavor decreased. As for shiitake mushroom powder in ethanol suspension treated with UVC-LED, the sweaty and almond odor scores decreased and the vitamin D2 content in mushroom caps and stems reached 668.79 μg/g (dw) and 399.45 μg/g (dw), respectively. The results obtained from this study demonstrate that UVC-LED treatment produced rich-flavored, quality mushroom products.

Modern approaches for detection of volatile organic compounds in metabolic studies focusing on pathogenic bacteria: Current state of the art

Pathogenic microorganisms produce numerous metabolites, including volatile organic compounds (VOCs). Monitoring these metabolites in biological matrices (e.g., urine, blood, or breath) can reveal the presence of specific microorganisms, enabling the early diagnosis of infections and the timely implementation of targeted therapy. However, complex matrices only contain trace levels of VOCs, and their constituent components can hinder determination of these compounds. Therefore, modern analytical techniques enabling the non-invasive identification and precise quantification of microbial VOCs are needed. In this paper, we discuss bacterial VOC analysis under in vitro conditions, in animal models and disease diagnosis in humans, including techniques for offline and online analysis in clinical settings. We also consider the advantages and limitations of novel microextraction techniques used to prepare biological samples for VOC analysis, in addition to reviewing current clinical studies on bacterial volatilomes that address inter-species interactions, the kinetics of VOC metabolism, and species- and drug-resistance specificity.

Rapid detection of Staphylococcus aureus and Streptococcus pneumoniae by real-time analysis of volatile metabolites

Early detection of pathogenic bacteria is needed for rapid diagnostics allowing adequate and timely treatment of infections. In this study, we show that secondary electrospray ionization–high resolution mass spectrometry (SESI-HRMS) can be used as a diagnostic tool for rapid detection of bacterial infections as a supportive system for current state-of-the-art diagnostics. Volatile organic compounds (VOCs) produced by growing S. aureus or S. pneumoniae cultures on blood agar plates were detected within minutes and allowed for the distinction of these two bacteria on a species and even strain level within hours. Furthermore, we obtained a fingerprint of clinical patient samples within minutes of measurement and predominantly observed a separation of samples containing live bacteria compared to samples with no bacterial growth. Further development of this technique may reduce the time required for microbiological diagnosis and should help to improve patient’s tailored treatment.

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Real-time mass spectrometry shows potential as a tool for microbiological diagnosis

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Bacterial volatile metabolites from 1 × 10³ CFUs are detected within minutes

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S. aureus and S. pneumoniae can be distinguished on species and even strain level

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Complex clinical samples cluster according to presence or absence of viable bacteria

Use of GC-IMS for detection of volatile organic compounds to identify mixed bacterial culture medium

In order to explore the possibility to identify common wound infection bacteria in mixed culture with gas chromatograph-ion migration spectroscopy (GC-IMS), the headspace gas of single and mixed cultures of Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa were detected and analyzed by GC-IMS system. The bacteria were cultured in thioglycolate medium tubes then transferred to the sampling bottles (indirect method), or directly cultured in the sampling bottles (direct method) to allow accumulation of volatile compounds and facilitate automation. The specific microorganism volatile organic compounds (mVOCs) of the three bacteria were obtained. Some of them have been known to certain substance, for example, ethanol, isoamyl acetate, Phenylacetaldehyde, 2-heptanone etc., while others have not. Principal component analysis (PCA) showed that a higher separability can be achieved with direct method than indirect method. This work indicated that it is possible to identify compound bacteria by detecting specific mVOCs with GC-IMS, and the specific mVOCs should be medium-dependent.

Noninvasive detection of COPD and Lung Cancer through breath analysis using MOS Sensor array based e-nose

INTRODUCTION

This paper describes the research work done toward the development of a breath analyzing electronic nose (e-nose), and the results obtained from testing patients with lung cancer, patients with chronic obstructive pulmonary disease (COPD), and healthy controls. Pulmonary diseases like COPD and lung cancer are detected with MOS sensor array-based e-noses. The e-nose device with the sensor array, data acquisition system, and pattern recognition can detect the variations of volatile organic compounds (VOC) present in the expelled breath of patients and healthy controls.

MATERIALS AND METHODS

This work presents the e-nose equipment design, study subjects selection, breath sampling procedures, and various data analysis tools. The developed e-nose system is tested in 40 patients with lung cancer, 48 patients with COPD, and 90 healthy controls.

RESULTS

In differentiating lung cancer and COPD from controls, support vector machine (SVM) with 3-fold cross-validation outperformed all other classifiers with an accuracy of 92.3% in cross-validation. In external validation, the same discrimination was achieved by k-nearest neighbors (k-NN) with 75.0% accuracy.

CONCLUSION

The reported results show that the VOC analysis with an e-nose system holds exceptional possibilities in noninvasive disease diagnosis applications.

Identification of volatile compounds from bacteria by spectrometric methods in medicine diagnostic and other areas: current state and perspectives

Diagnosis of bacterial infections until today mostly relies on conventional microbiological methods. The resulting long turnaround times can lead to delayed initiation of adequate antibiotic therapy and prolonged periods of empiric antibiotic therapy (e.g., in intensive care medicine). Therewith, they contribute to the mortality of bacterial infections and the induction of multidrug resistances. The detection of species specific volatile organic compounds (VOCs) emitted by bacteria has been proposed as a possible diagnostic approach with the potential to serve as an innovative point-of-care diagnostic tool with very short turnaround times. A range of spectrometric methods are available which allow the detection and quantification of bacterial VOCs down to a range of part per trillion. This narrative review introduces the application of spectrometric analytical methods for the purpose of detecting VOCs of bacterial origin and their clinical use for diagnosing different infectious conditions over the last decade. KEY POINTS: • Detection of VOCs enables bacterial differentiation in various medical conditions. • Spectrometric methods may function as point-of-care diagnostics in near future.

Exploratory Study Using Urinary Volatile Organic Compounds for the Detection of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) biomarkers are lacking in clinical practice. We therefore explored the pattern and composition of urinary volatile organic compounds (VOCs) in HCC patients. This was done in order to assess the feasibility of a potential non-invasive test for HCC, and to enhance our understanding of the disease. This pilot study recruited 58 participants, of whom 20 were HCC cases and 38 were non-HCC cases. The non-HCC cases included healthy individuals and patients with various stages of non-alcoholic fatty liver disease (NAFLD), including those with and without fibrosis. Urine was analysed using gas chromatography-ion mobility spectrometry (GC-IMS) and gas chromatography-time-of-flight mass spectrometry (GC-TOF-MS). GC-IMS was able to separate HCC from fibrotic cases with an area under the curve (AUC) of 0.97 (0.91-1.00), and from non-fibrotic cases with an AUC of 0.62 (0.48-0.76). For GC-TOF-MS, a subset of samples was analysed in which seven chemicals were identified and tentatively linked with HCC. These include 4-methyl-2,4-bis(p-hydroxyphenyl)pent-1-ene (2TMS derivative), 2-butanone, 2-hexanone, benzene, 1-ethyl-2-methyl-, 3-butene-1,2-diol, 1-(2-furanyl)-, bicyclo(4.1.0)heptane, 3,7,7-trimethyl-, [1S-(1a,3β,6a)]-, and sulpiride. Urinary VOC analysis using both GC-IMS and GC-TOF-MS proved to be a feasible method of identifying HCC cases, and was also able to enhance our understanding of HCC pathogenesis.

Noninvasive Early Disease Diagnosis by Electronic-Nose and Related VOC-Detection Devices

This editorial provides an overview and summary of recent research articles published in Biosensors journal, volumes 9 (2019) and 10 (2020), within the Special Issue "Noninvasive Early Disease Diagnosis", which focused on recent sensors, biosensors, and clinical instruments developed for the noninvasive early detection and diagnosis of human, animal, and plant diseases or invasive pests. The six research articles included in this Special Issue provide examples of some of the latest electronic-nose (e-nose) and related volatile organic compound (VOC)-detection technologies, which are being tested and developed to improve the effectiveness and efficiency of innovative diagnostic methodologies for the early detection of particular diseases and pest infestations in living hosts, prior to symptom development.