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J Pediatr Gastroenterol Nutr

Title:		Detection of Sepsis in Preterm Infants by Fecal Volatile Organic Compounds Analysis: A Proof of Principle Study
Author(s):		Berkhout DJC; Niemarkt HJ; Buijck M; van Weissenbruch MM; Brinkman P; Benninga MA; van Kaam AH; Kramer BW; Andriessen P; de Boer NKH; de Meij TGJ;
Address:		"*Department of Pediatric Gastroenterology, VU University Medical Center daggerDepartment of Pediatric Gastroenterology, Emma Children's Hospital/Academic Medical Center, Amsterdam double daggerNeonatal Intensive Care Unit, Maxima Medical Center, Veldhoven section signNeonatal Intensive Care Unit, VU University Medical Center ||Department of Respiratory Medicine, Academic Medical Center paragraph signNeonatal Intensive Care Unit, Emma Children's Hospital/Academic Medical Center, Amsterdam #Department of Pediatrics, Maastricht University Medical Center, Maastricht **Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, The Netherlands"
Journal Title:		J Pediatr Gastroenterol Nutr
Year:		2017
Volume:		65
Issue:		3
Page Number:		e47 - e52
DOI:		10.1097/MPG.0000000000001471
ISSN/ISBN:		1536-4801 (Electronic) 0277-2116 (Linking)
Abstract:		"OBJECTIVES: Several studies associated altered gut microbiota composition in preterm infants with late-onset sepsis (LOS), up to days before clinical onset of sepsis. Microbiota analysis as early diagnostic biomarker is, however, in clinical practice currently not feasible because of logistic aspects and high costs. Therefore, we hypothesized that analysis of fecal volatile organic compounds (VOCs) may serve as noninvasive biomarker to predict LOS at a preclinical stage, because VOC reflect the composition and activity of intestinal microbial communities. METHODS: In a prospective multicenter study, fecal samples were collected daily from infants with a gestational age of <30 weeks. VOC signatures of fecal samples from infants with LOS, collected up to 5 days before diagnosis, were analyzed by means of an electronic nose technology (Cyranose 320) and compared to matched controls. RESULTS: Fecal VOC profiles of infants with LOS (n = 36) could be discriminated from controls (n = 40) at 3 days (area under the curve [+/-95% confidence interval], P value, sensitivity, specificity; 70.2 [52.2-88.3], 0.033, 57.1%, 61.5%), 2 days (77.7 [62.7-92.7], 0.050, 75.0%, 70.8%), and 1 day (70.4 [49.6-91.3], 0.037, 64.3%, 64.3%) before the onset of LOS. CONCLUSIONS: Fecal VOC profiles of preterm infants with LOS could be discriminated from matched controls, up to 3 days before clinical onset of the disease, underlining the hypothesis that intestinal microbiota may play an etiological role in LOS. Notably, VOC profiling is clinically feasible and the potential of this technique in the early detection of LOS needs to be confirmed in future studies"
Keywords:		"Biomarkers/metabolism Case-Control Studies Electronic Nose Feces/*chemistry Female *Gastrointestinal Microbiome Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases/*diagnosis/metabolism/microbiology Male Neonatal Sepsis/*diagnosis/metabol;"
Notes:		"MedlineBerkhout, Daniel J C Niemarkt, Hendrik J Buijck, Martin van Weissenbruch, Mirjam M Brinkman, Paul Benninga, Marc A van Kaam, Anton H Kramer, Boris W Andriessen, Peter de Boer, Nanne K H de Meij, Tim G J eng Clinical Trial Multicenter Study 2016/11/16 J Pediatr Gastroenterol Nutr. 2017 Sep; 65(3):e47-e52. doi: 10.1097/MPG.0000000000001471"