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J Cyst Fibros

Title:		Targeted exhaled breath analysis for detection of Pseudomonas aeruginosa in cystic fibrosis patients
Author(s):		Kos R; Brinkman P; Neerincx AH; Paff T; Gerritsen MG; Lammers A; Kraneveld AD; Heijerman HGM; Janssens HM; Davies JC; Majoor CJ; Weersink EJ; Sterk PJ; Haarman EG; Bos LD; Maitland-van der Zee AH; Amsterdam Mucociliary Clearance Disease Research G; the Amsterdam UMCB;
Address:		"Department Respiratory Medicine, Amsterdam University Medical Centres - loc. AMC, University of Amsterdam, Amsterdam, Netherlands. Department Paediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, the Netherlands. Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands; Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands. Department Respiratory Medicine, University Medical Centre, Utrecht, Netherlands. Department of Paediatrics, Division Respiratory Medicine and Allergology, Erasmus MC/Sophia Children's Hospital, University Medical Centre, Rotterdam, Netherlands. National Heart and Lung Institute, Imperial College London, London, United Kingdom; Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom. Department Respiratory Medicine, Amsterdam University Medical Centres - loc. AMC, University of Amsterdam, Amsterdam, Netherlands; Department of Intensive Care, Amsterdam University Medical Centres, University of Amsterdam, Netherlands. Department Respiratory Medicine, Amsterdam University Medical Centres - loc. AMC, University of Amsterdam, Amsterdam, Netherlands; Department Paediatric Respiratory Medicine and Allergy, Emma Children's Hospital, Amsterdam University Medical Centres, Amsterdam, the Netherlands. Electronic address: a.h.maitland@amsterdamumc.nl"
Journal Title:		J Cyst Fibros
Year:		2022
Volume:		20210518
Issue:		1
Page Number:		e28 - e34
DOI:		10.1016/j.jcf.2021.04.015
ISSN/ISBN:		1873-5010 (Electronic) 1569-1993 (Linking)
Abstract:		"BACKGROUND: Pseudomonas aeruginosa (PA) is an important respiratory pathogen for cystic fibrosis (CF) patients. Routine microbiology surveillance is time-consuming, and is best performed on expectorated sputum. As alternative, volatile organic compounds (VOCs) may be indicative of PA colonisation. In this study, we aimed to identify VOCs associated with PA in literature and perform targeted exhaled breath analysis to recognize PA positive CF patients non-invasively. METHODS: This study consisted of 1) a literature review to select VOCs of interest, and 2) a cross-sectional CF study. Definitions used: A) PA positive, PA culture at visit/chronically; B) PA free, no PA culture in >/=12 months. Exhaled VOCs were identified via quadrupole MS. The primary endpoint was the area under the receiver operating characteristics curve (AUROCC) of individual VOCs as well as combined VOCs against PA culture. RESULTS: 241 VOCs were identified in literature, of which 56 were further evaluated, and 13 could be detected in exhaled breath in our cohort. Exhaled breath of 25 pediatric and 28 adult CF patients, PA positive (n=16) and free (n=28) was available. 3/13 VOCs were significantly (p<0.05) different between PA groups in children; none were in adults. Notably, a composite model based on 5 or 1 VOC(s) showed an AUROCC of 0.86 (CI 0.71-1.0) and 0.87 (CI 0.72-1.0) for adults and children, respectively. CONCLUSIONS: Targeted VOC analysis appears to discriminate children and adults with and without PA positive cultures with clinically acceptable sensitivity values"
Keywords:		Adolescent Adult Breath Tests/*methods Cross-Sectional Studies Cystic Fibrosis/*microbiology Exhalation Female Humans Longitudinal Studies Male Pseudomonas Infections/*diagnosis Pseudomonas aeruginosa Volatile Organic Compounds/*analysis Young Adult Cysti;
Notes:		"MedlineKos, Renate Brinkman, Paul Neerincx, Anne H Paff, Tamara Gerritsen, Marije G Lammers, Ariana Kraneveld, Aletta D Heijerman, Harry G M Janssens, Hettie M Davies, Jane C Majoor, Christof J Weersink, Els J Sterk, Peter J Haarman, Eric G Bos, Lieuwe D Maitland-van der Zee, Anke H (AMCD) eng Research Support, Non-U.S. Gov't Review Netherlands 2021/05/22 J Cyst Fibros. 2022 Jan; 21(1):e28-e34. doi: 10.1016/j.jcf.2021.04.015. Epub 2021 May 18"