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Faecal volatile biomarkers of Clostridium difficile infection

Care of patients with potential CDI can involve isolation and use of antibiotics, often before a definitive diagnosis is available, impacting healthcare resource and contributing to antibiotic resistance. There is anecdotal evidence that the faeces of CDI patients have a distinctive odour, while it...

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Autores principales: Patel, Mitesh, Fowler, Dawn, Sizer, Jeremy, Walton, Christopher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464219/
https://www.ncbi.nlm.nih.gov/pubmed/30986230
http://dx.doi.org/10.1371/journal.pone.0215256
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author Patel, Mitesh
Fowler, Dawn
Sizer, Jeremy
Walton, Christopher
author_facet Patel, Mitesh
Fowler, Dawn
Sizer, Jeremy
Walton, Christopher
author_sort Patel, Mitesh
collection PubMed
description Care of patients with potential CDI can involve isolation and use of antibiotics, often before a definitive diagnosis is available, impacting healthcare resource and contributing to antibiotic resistance. There is anecdotal evidence that the faeces of CDI patients have a distinctive odour, while it is well-established that changes in the gut microbiota are associated with changes in the volatile organic compounds (VOC) produced. A total of twenty-four candidate volatile biomarkers were identified from a review of the literature including in vitro, animal and human studies. Using thermal desorption-gas chromatography-time-of flight mass spectrometry (TD-GC-ToFMS), VOC emission rates were determined on stored frozen stool samples from 53 CDI-positive and 53 CDI-negative patients with unexplained diarrhoea which had previously been diagnosed using enzymatic and nucleic acid amplification tests. Sample preparation was limited to placement of a subsample in an appropriate container. Compounds exhibiting a statistically significant difference (p < 0.05) in emission rate between the CDI-positive and–negative groups and a corresponding area under the receiver-operator characteristic curve (ROC) >0.7 were considered potentially indicative of CDI. Seven compounds were so identified: propan-1-ol (ROC 0.75), 3-methylbutanal (ROC 0.84), ethyl propionate (ROC 0.81), hexanoic acid (ROC 0.73), 4-methylphenol (ROC 0.81), dodecane (ROC 0.80) and indole (ROC 0.85). A number of potential volatile biomarkers of CDI can be sampled rapidly and with little prior preparation from faecal samples of patients with diarrhoea. Of these 4-methylphenol (p-cresol) is of particular interest as it has been anecdotally linked to CDI and is closely related to the biology and virulence of Clostridium difficile. This approach shows promise for the rapid, point-of-care diagnosis of CDI with good sensitivity and specificity.
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spelling pubmed-64642192019-05-03 Faecal volatile biomarkers of Clostridium difficile infection Patel, Mitesh Fowler, Dawn Sizer, Jeremy Walton, Christopher PLoS One Research Article Care of patients with potential CDI can involve isolation and use of antibiotics, often before a definitive diagnosis is available, impacting healthcare resource and contributing to antibiotic resistance. There is anecdotal evidence that the faeces of CDI patients have a distinctive odour, while it is well-established that changes in the gut microbiota are associated with changes in the volatile organic compounds (VOC) produced. A total of twenty-four candidate volatile biomarkers were identified from a review of the literature including in vitro, animal and human studies. Using thermal desorption-gas chromatography-time-of flight mass spectrometry (TD-GC-ToFMS), VOC emission rates were determined on stored frozen stool samples from 53 CDI-positive and 53 CDI-negative patients with unexplained diarrhoea which had previously been diagnosed using enzymatic and nucleic acid amplification tests. Sample preparation was limited to placement of a subsample in an appropriate container. Compounds exhibiting a statistically significant difference (p < 0.05) in emission rate between the CDI-positive and–negative groups and a corresponding area under the receiver-operator characteristic curve (ROC) >0.7 were considered potentially indicative of CDI. Seven compounds were so identified: propan-1-ol (ROC 0.75), 3-methylbutanal (ROC 0.84), ethyl propionate (ROC 0.81), hexanoic acid (ROC 0.73), 4-methylphenol (ROC 0.81), dodecane (ROC 0.80) and indole (ROC 0.85). A number of potential volatile biomarkers of CDI can be sampled rapidly and with little prior preparation from faecal samples of patients with diarrhoea. Of these 4-methylphenol (p-cresol) is of particular interest as it has been anecdotally linked to CDI and is closely related to the biology and virulence of Clostridium difficile. This approach shows promise for the rapid, point-of-care diagnosis of CDI with good sensitivity and specificity. Public Library of Science 2019-04-15 /pmc/articles/PMC6464219/ /pubmed/30986230 http://dx.doi.org/10.1371/journal.pone.0215256 Text en © 2019 Patel et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Patel, Mitesh
Fowler, Dawn
Sizer, Jeremy
Walton, Christopher
Faecal volatile biomarkers of Clostridium difficile infection
title Faecal volatile biomarkers of Clostridium difficile infection
title_full Faecal volatile biomarkers of Clostridium difficile infection
title_fullStr Faecal volatile biomarkers of Clostridium difficile infection
title_full_unstemmed Faecal volatile biomarkers of Clostridium difficile infection
title_short Faecal volatile biomarkers of Clostridium difficile infection
title_sort faecal volatile biomarkers of clostridium difficile infection
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464219/
https://www.ncbi.nlm.nih.gov/pubmed/30986230
http://dx.doi.org/10.1371/journal.pone.0215256
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