Volatile molecules from bronchoalveolar lavage fluid can 'rule-in' Pseudomonas aeruginosa and 'rule-out' Staphylococcus aureus infections in cystic fibrosis patients

Mavra Nasir, Heather Bean, Agnieszka Smolinska, Christiaan A. Rees, Edith T. Zemanick, Jane E. Hill

    Research output: Contribution to journalArticle

    4 Citations (Scopus)

    Abstract

    Respiratory infections caused by Pseudomonas aeruginosa and Staphylococcus aureus are the leading cause of morbidity and mortality in cystic fibrosis (CF) patients. The authors aimed to identify volatile biomarkers from bronchoalveolar lavage (BAL) samples that can guide breath biomarker development for pathogen identification. BAL samples (n = 154) from CF patients were analyzed using two-dimensional gas chromatography time-of-flight mass spectrometry. Random Forest was used to select suites of volatiles for identifying P. aeruginosa-positive and S. aureus-positive samples using multiple infection scenarios and validated using test sets. Using nine volatile molecules, we differentiated P. aeruginosa-positive (n = 7) from P. aeruginosa-negative (n = 53) samples with an area under the receiver operating characteristic curve (AUROC) of 0.86 (95% CI 0.71-1.00) and with positive and negative predictive values of 0.67 (95% CI 0.38-0.75) and 0.92 (95% CI 0.88-1.00), respectively. We were also able to discriminate S. aureus-positive (n = 15) from S. aureus-negative (n = 45) samples with an AUROC of 0.88 (95% CI 0.79-1.00) using eight volatiles and with positive and negative predictive values of 0.86 (95% CI 0.61-0.96) and 0.70 (95% CI 0.61-0.75), respectively. Prospective validation of identified biomarkers as screening tools in patient breath may lead to clinical application.

    Original languageEnglish (US)
    Article number826
    JournalScientific Reports
    Volume8
    Issue number1
    DOIs
    StatePublished - Dec 1 2018

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    Bronchoalveolar Lavage Fluid
    Cystic Fibrosis
    Pseudomonas aeruginosa
    Staphylococcus aureus
    Biomarkers
    Bronchoalveolar Lavage
    Infection
    ROC Curve
    Respiratory Tract Infections
    Gas Chromatography
    Mass Spectrometry
    Morbidity
    Mortality

    ASJC Scopus subject areas

    • General

    Cite this

    Volatile molecules from bronchoalveolar lavage fluid can 'rule-in' Pseudomonas aeruginosa and 'rule-out' Staphylococcus aureus infections in cystic fibrosis patients. / Nasir, Mavra; Bean, Heather; Smolinska, Agnieszka; Rees, Christiaan A.; Zemanick, Edith T.; Hill, Jane E.

    In: Scientific Reports, Vol. 8, No. 1, 826, 01.12.2018.

    Research output: Contribution to journalArticle

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    abstract = "Respiratory infections caused by Pseudomonas aeruginosa and Staphylococcus aureus are the leading cause of morbidity and mortality in cystic fibrosis (CF) patients. The authors aimed to identify volatile biomarkers from bronchoalveolar lavage (BAL) samples that can guide breath biomarker development for pathogen identification. BAL samples (n = 154) from CF patients were analyzed using two-dimensional gas chromatography time-of-flight mass spectrometry. Random Forest was used to select suites of volatiles for identifying P. aeruginosa-positive and S. aureus-positive samples using multiple infection scenarios and validated using test sets. Using nine volatile molecules, we differentiated P. aeruginosa-positive (n = 7) from P. aeruginosa-negative (n = 53) samples with an area under the receiver operating characteristic curve (AUROC) of 0.86 (95{\%} CI 0.71-1.00) and with positive and negative predictive values of 0.67 (95{\%} CI 0.38-0.75) and 0.92 (95{\%} CI 0.88-1.00), respectively. We were also able to discriminate S. aureus-positive (n = 15) from S. aureus-negative (n = 45) samples with an AUROC of 0.88 (95{\%} CI 0.79-1.00) using eight volatiles and with positive and negative predictive values of 0.86 (95{\%} CI 0.61-0.96) and 0.70 (95{\%} CI 0.61-0.75), respectively. Prospective validation of identified biomarkers as screening tools in patient breath may lead to clinical application.",
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