Abstract
IntroductionChronic pulmonary infection is the hallmark of Cystic Fibrosis lung disease. Searching for faster and easier screening may lead to faster diagnosis and treatment of Pseudomonas aeruginosa (P. aeruginosa). Our aim was to analyze and build a model to predict the presence of P. aeruginosa in sputa.MethodsSputa from 28 bronchiectatic patients were used for bacterial culturing and analysis of volatile compounds by gas chromatography–mass spectrometry. Data analysis and model building were done by Partial Least Squares Regression Discriminant analysis (PLS-DA). Two analysis were performed: one comparing P. aeruginosa positive with negative cultures at study visit (PA model) and one comparing chronic colonization according to the Leeds criteria with P. aeruginosa negative patients (PACC model).ResultsThe PA model prediction of P. aeruginosa presence was rather poor, with a high number of false positives and false negatives. On the other hand, the PACC model was stable and explained chronic P. aeruginosa presence for 95% with 4 PLS-DA factors, with a sensitivity of 100%, a positive predictive value of 86% and a negative predictive value of 100%.ConclusionOur study shows the potential for building a prediction model for the presence of chronic P. aeruginosa based on volatiles from sputum.
Highlights
Chronic pulmonary infection is the hallmark of Cystic Fibrosis lung disease
Population During the study period 30 patients were recruited and sputum was analyzed of patients (male (43%); average age y ± 12; 11% non-Cystic Fibrosis (CF) bronchiectasis and 89% CF)
Bacterial culturing of the 28 patients showed that 14 patients had P. aeruginosa in their sputa (50%) collected at the time of the study
Summary
Chronic pulmonary infection is the hallmark of Cystic Fibrosis lung disease. Searching for faster and easier screening may lead to faster diagnosis and treatment of Pseudomonas aeruginosa (P. aeruginosa). Chronic P. aeruginosa infection is normally preceded by an intermittent presence of the bacteria [10]. Eradication during this period is important to delay. A positive culture should not be regarded as a gold standard for diagnosing (chronic) P. aeruginosa infection in CF patients with bronchiectasis and repeated culturing is still a cornerstone of a possible classification based on both bacterial cultures and specific antibody analysis [16]. Repeated culturing is the cornerstone in non-CF bronchiectasis for the diagnosis of chronic P. aerugiosa different definitions are used [17]. P. aeruginosa may be detected by analyzing VOCs produced in vitro (Table 1), the many studies addressing this question measured a variable range of VOCs. Breath or
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