Abstract

Introduction Giardiasis is a common but neglected intestinal infection worldwide, caused by the flagellated intestinal protozoan Giardia duodenalis (syn. lamblia/intestinalis ). Several methods are available for the laboratory diagnosis of Giardia . It has unique metabolic pathways related to its lack of mitochondria, making it an ideal target for volatile organic compound profiling. Method Faecal gas headspace extraction and Gas Chromatography-Mass Spectrometry (GCMS) were used to extract and identify VOCs. Analytical tools including Metab, 1 R and Metaboanalyst 2 were subsequently used. Stool was obtained from patients with confirmed isolated Giardia infection, together with stool from subjects with diarrhoea but no identifiable infection, including Giardia , these acted as controls. Significant differences between the VOCs were then analysed. Results The composition of these compounds was dominated by Esters, Acids and Alcohols, respectively. With an absence of Amides, Alicyclic compounds, Ether compounds and Nitrogen Containing compounds. >100 VOCs were identified across both the control and Giardia groups. Of these 10 were noted to be significantly different between the two groups (p Giardia samples, 2,2,4,4-tetramethyloctan, acetic acid and 2,2,4,6,6-pentamethylhepatance (p Giardia samples. PLS-DA showed a good degree of separation. AUROC analysis gave 5 VOCs with an AUC between 0.8 and 0.93. Conclusion There is a significant difference in the VOC profile of stool from subjects infected with Giardia spp , when compared to non-infected controls, both in terms of prevalence and abundance. There is also a defined metabolic reason for this difference originating from the unique metabolic pathways seen in Giardia . Disclosure of interest None Declared. References Aggio R, Villas-Boas SG, Ruggiero K. Metab: an R package for high-throughput analysis of metabolomics data generated by GC-MS. Bioinformatics (Oxford, England) 2011; 27 :2316–2318. doi:10.1093/bioinformatics/btr379 Xia J, Psychogios N, Young N, and Wishart DS. MetaboAnalyst: a web server for metabolomic data analysis and interpretation. Nucl Acids Res. 2009;37:W652–660.

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