Exhaled breath profiles to detect lung infection with Staphylococcus aureus in children with cystic fibrosis

Johann-Christoph Licht; Elias Seidl; Gitte Slingers; Valerie Waters; Rianne de Vries; Martin Post; Felix Ratjen; Hartmut Grasemann

doi:10.1016/j.jcf.2023.02.010

Exhaled breath profiles to detect lung infection with Staphylococcus aureus in children with cystic fibrosis

J Cyst Fibros. 2023 Sep;22(5):888-893. doi: 10.1016/j.jcf.2023.02.010. Epub 2023 Feb 26.

Authors

Johann-Christoph Licht¹, Elias Seidl², Gitte Slingers³, Valerie Waters⁴, Rianne de Vries³, Martin Post⁵, Felix Ratjen¹, Hartmut Grasemann⁶

Affiliations

¹ Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children, Toronto, ON M5G 1 X 8, Canada and University of Toronto; Translational Medicine, Research Institute, Hospital for Sick Children, Toronto, ON M5G 1 × 8, Canada.
² Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children, Toronto, ON M5G 1 X 8, Canada and University of Toronto.
³ Breathomix BV, Bargelaan 200, 2333 CW Leiden, the Netherlands.
⁴ Translational Medicine, Research Institute, Hospital for Sick Children, Toronto, ON M5G 1 × 8, Canada; Division of Infectious Diseases, Department of Pediatrics, Hospital for Sick Children, Toronto, ON M5G 1 X 8, Canada and University of Toronto.
⁵ Translational Medicine, Research Institute, Hospital for Sick Children, Toronto, ON M5G 1 × 8, Canada.
⁶ Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children, Toronto, ON M5G 1 X 8, Canada and University of Toronto; Translational Medicine, Research Institute, Hospital for Sick Children, Toronto, ON M5G 1 × 8, Canada. Electronic address: Hartmut.Grasemann@sickkids.ca.

PMID: 36849333
DOI: 10.1016/j.jcf.2023.02.010

Abstract

Background: An electronic nose (eNose) can be used to detect volatile organic compounds (VOCs). Exhaled breath contains numerous VOCs and individuals' VOCs mixtures create distinct breath profiles. Previous reports have shown that eNose can detect lung infections. Whether eNose can detect Staphylococcus aureus airway infections in breath of children with cystic fibrosis (CF) is currently unclear.

Methods: In this cross-sectional observational study, a cloud-connected eNose was used for breath profile analysis of clinically stable paediatric CF patients with airway microbiology cultures positive or negative for CF pathogens. Data-analysis involved advanced signal processing, ambient correction and statistics based on linear discriminant and receiver operating characteristics (ROC) analyses.

Results: Breath profiles from 100 children with CF (median predicted FEV₁ 91%) were obtained and analysed. CF patients with positive airway cultures for any CF pathogen were distinguishable from no CF pathogens (no growth or usual respiratory flora) with accuracy of 79.0% (AUC-ROC 0.791; 95% CI: 0.669-0.913) and between patients positive for Staphylococcus aureus (SA) only and no CF pathogen with accuracy of 74.0% (AUC-ROC 0.797; 95% CI: 0.698-0.896). Similar differences were seen for Pseudomonas aeruginosa (PA) infection vs no CF pathogens (78.0% accuracy, AUC-ROC 0.876, 95% CI: 0.794-0.958). SA- and PA-specific signatures were driven by different sensors in the SpiroNose suggesting pathogen-specific breath signatures.

Conclusions: Breath profiles of CF patients with SA in airway cultures are distinct from those with no infection or PA infection, suggesting the utility of eNose technology in the detection of this early CF pathogen in children with CF.

Keywords: Cystic fibrosis; Electronic nose; Pseudomonas aeruginosa; Respiratory disease; Respiratory infections; Staphylococcus aureus; Volatile organic compounds.

Publication types

Observational Study

MeSH terms

Breath Tests
Child
Cross-Sectional Studies
Cystic Fibrosis* / complications
Cystic Fibrosis* / diagnosis
Cystic Fibrosis* / microbiology
Humans
Lung
Pneumonia*
Pseudomonas Infections* / diagnosis
ROC Curve
Staphylococcus aureus
Volatile Organic Compounds* / analysis

Substances

Volatile Organic Compounds