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John TM, Shrestha N, Hasan L, Pappan K, Birch O, Grove DE, Boyle B, Allsworth M, Shrestha P, Procop G, Dweik RA. Detection of Clostridioides difficileinfection by assessment of exhaled breath volatile organic compounds. J Breath Res 2024. [PMID: 38502958 DOI: 10.1088/1752-7163/ad3572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Clostridioides difficileinfection (CDI) is the leading cause of hospital-acquired infective diarrhea. Current methods for diagnosing CDI have limitations; enzyme immunoassays for toxin have low sensitivity andClostridioides difficilePCR cannot differentiate infection from colonization. An ideal diagnostic test that incorporates microbial factors, host factors, and host-microbe interaction might characterize true infection. Assessing volatile organic compounds (VOCs) in exhaled breath may be a useful test for identifying CDI. To identify a wide selection of VOCs in exhaled breath, we used thermal desorption-gas chromatography-mass spectrometry to study breath samples from 17 patients with CDI. Age- and sex-matched patients with diarrhea and negative C.difficile testing (no CDI) were used as controls. Of the 65 VOCs tested, 9 were used to build a quadratic discriminant model that showed a final cross-validated accuracy of 74%, a sensitivity of 71%, a specificity of 76%, and a receiver operating characteristic area under the curve of 0.72. If these findings are proven by larger studies, breath VOC analysis may be a helpful adjunctive diagnostic test for CDI.
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Affiliation(s)
- Teny M John
- Infectious Diseases, UH MD Anderson Library, 1515 Holcombe Blvd, Houston, Texas, 77204-2000, UNITED STATES
| | - Nabin Shrestha
- Infectious Disease/Medicine Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, USA, Cleveland, 44195, UNITED STATES
| | - Leen Hasan
- Medicine, Columbia University Irving Medical Center, New York, New York, New York, 10032-3784, UNITED STATES
| | - Kirk Pappan
- Acclivity technology, 6135 Park South Drive Ste 510, Charlotte, NC, Charlotte, 28210, UNITED STATES
| | - Owen Birch
- Owlstone Medical Ltd, 183 Cambridge Science Park, Cambridge, CB4 0GJ, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - David E Grove
- Inflammation and Immunity, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA, Cleveland , Ohio, 44195, UNITED STATES
| | - Billy Boyle
- Owlstone Ltd, Owlstone Inc., Cambridge, Cambridgeshire, CB4 0GJ, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Max Allsworth
- Owlstone Ltd, 183 Cambridge Science Park Milton Road Cambridge, Cambridge, Cambridgeshire, CB4 0GJ, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Priyanka Shrestha
- Computer Science, Stanford University, Stanford, California, Stanford, California, 94305-6104, UNITED STATES
| | - Gary Procop
- The American Board of Pathology, Tampa Florida, Tampa, Florida, 33609-2571, UNITED STATES
| | - Raed A Dweik
- Departments of Pulmonary and Critical Care Medicine / Respiratory Institute, and Pathobiology / Lerner Research Institute, Cleveland Clinic Foundation, Director, Cleveland Clinic, Cleveland, Ohio, 44195, cleveland, Ohio, 44195, UNITED STATES
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