Abstract

Presently, 2 to 4 days elapse between sampling at infection suspicion and result of microbial diagnostics. This delay for the identification of pathogens causes quite often a late and/or inappropriate initiation of therapy for patients suffering from infections. Bad outcome and high hospitalization costs are the consequences of these currently existing limited pathogen identification possibilities. For this reason, we aimed to apply the innovative method multi-capillary column–ion mobility spectrometry (MCC-IMS) for a fast identification of human pathogenic bacteria by determination of their characteristic volatile metabolomes. We determined volatile organic compound (VOC) patterns in headspace of 15 human pathogenic bacteria, which were grown for 24 h on Columbia blood agar plates. Besides MCC-IMS determination, we also used thermal desorption–gas chromatography–mass spectrometry measurements to confirm and evaluate obtained MCC-IMS data and if possible to assign volatile compounds to unknown MCC-IMS signals. Up to 21 specific signals have been determined by MCC-IMS for Proteus mirabilis possessing the most VOCs of all investigated strains. Of particular importance is the result that all investigated strains showed different VOC patterns by MCC-IMS using positive and negative ion mode for every single strain. Thus, the discrimination of investigated bacteria is possible by detection of their volatile organic compounds in the chosen experimental setup with the fast and cost-effective method MCC-IMS. In a hospital routine, this method could enable the identification of pathogens already after 24 h with the consequence that a specific therapy could be initiated significantly earlier.

Highlights

  • The treatment of suspected bacterial infections like pneumonia or sepsis represents a difficult dilemma for the clinician

  • All bacterial strains investigated in this study release volatile organic compounds detectable with multi-capillary column–ion mobility spectrometry (MCC-Ion mobility spectrometry (IMS)) (Table 1)

  • Results of thermal desorption GC/MS analysis confirmed the fact that bacteria can be discriminated by their volatile organic compound (VOC) patterns (Table 3, Fig. 4)

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Summary

Introduction

The treatment of suspected bacterial infections like pneumonia or sepsis represents a difficult dilemma for the clinician. Due to a lack of knowledge about the identity of infecting pathogen at the point of infection suspicion, initial treatment mostly starts with broad-spectrum antibiotic therapy followed by narrow-spectrum therapy according to results of microbiological diagnostic. The argument for this strategy is that several studies showed that immediate initiation of an appropriate antibiotic therapy was associated with reduced mortality, reduced length of intensive care unit (ICU) stay and reduced costs (e.g., Kollef 2000; AlvarezLerma 1996; Rello et al 1997; Kumar et al 2009). A fast and efficient determination of pathogens is urgently needed to immediately initiate an appropriate therapy with infection suspicion. The results are not available early enough to guide antibiotic management in an early stage of the treatment

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