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PLoS One

Title:		"Diagnosis of Clostridioides difficile infection by analysis of volatile organic compounds in breath, plasma, and stool: A cross-sectional proof-of-concept study"
Author(s):		John TM; Shrestha NK; Procop GW; Grove D; Leal SM; Jacob CN; Butler R; Dweik R;
Address:		"Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, United States of America. Department of Infectious Disease, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America. Department of Laboratory Medicine and Pathology, Cleveland Clinic, Cleveland, Ohio, United States of America. Department of Pulmonary Medicine and Critical Care, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America. Department of Laboratory Medicine and Pathology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America. Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America. Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America. Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio, United States of America"
Journal Title:		PLoS One
Year:		2021
Volume:		20210818
Issue:		8
Page Number:		e0256259 -
DOI:		10.1371/journal.pone.0256259
ISSN/ISBN:		1932-6203 (Electronic) 1932-6203 (Linking)
Abstract:		"Clostridioides difficile infection (CDI) is an important infectious cause of antibiotic-associated diarrhea, with significant morbidity and mortality. Current diagnostic algorithms are based on identifying toxin by enzyme immunoassay (EIA) and toxin gene by real-time polymerase chain reaction (PCR) in patients with diarrhea. EIA's sensitivity is poor, and PCR, although highly sensitive and specific, cannot differentiate infection from colonization. An ideal test that incorporates microbial factors, host factors, and host-microbe interaction might characterize true infection, and assess prognosis and recurrence. The study of volatile organic compounds (VOCs) has the potential to be an ideal diagnostic test. The presence of VOCs accounts for the characteristic odor of stool in CDI but their presence in breath and plasma has not been studied yet. A cross-sectional proof-of-concept study analyzing VOCs using selected ion flow tube mass spectrometry (SIFT-MS) was done on breath, stool, and plasma of patients with clinical features and positive PCR for CDI (cases) and compared with patients with clinical features but a negative PCR (control). Our results showed that VOC patterns in breath, stool, and plasma, had good accuracy [area under the receiver operating characteristic curve (ROC) 93%, 86%, and 91%, respectively] for identifying patients with CDI"
Keywords:		Adult Aged Area Under Curve Biomarkers/analysis Breath Tests/*methods Clostridioides difficile/growth & development/*metabolism/pathogenicity Clostridium Infections/*diagnosis/metabolism/microbiology Cross-Sectional Studies Diarrhea/*diagnosis/metabolism/;
Notes:		"MedlineJohn, Teny M Shrestha, Nabin K Procop, Gary W Grove, David Leal, Sixto M Jr Jacob, Ceena N Butler, Robert Dweik, Raed eng Research Support, Non-U.S. Gov't 2021/08/19 PLoS One. 2021 Aug 18; 16(8):e0256259. doi: 10.1371/journal.pone.0256259. eCollection 2021"