Abstract

Urinary tract infection (UTI) is a common disease with significant morbidity and economic burden, accounting for a significant part of the workload in clinical microbiology laboratories. Current clinical chemisty point-of-care diagnostics rely on imperfect dipstick analysis which only provides indirect and insensitive evidence of urinary bacterial pathogens. An electronic nose (eNose) is a handheld device mimicking mammalian olfaction that potentially offers affordable and rapid analysis of samples without preparation at athmospheric pressure. In this study we demonstrate the applicability of ion mobility spectrometry (IMS) –based eNose to discriminate the most common UTI pathogens from gaseous headspace of culture plates rapidly and without sample preparation. We gathered a total of 101 culture samples containing four most common UTI bacteries: E. coli, S. saprophyticus, E. faecalis, Klebsiella spp and sterile culture plates. The samples were analyzed using ChemPro 100i device, consisting of IMS cell and six semiconductor sensors. Data analysis was conducted by linear discriminant analysis (LDA) and logistic regression (LR). The results were validated by leave-one-out and 5-fold cross validation analysis. In discrimination of sterile and bacterial samples sensitivity of 95% and specificity of 97% were achieved. The bacterial species were identified with sensitivity of 95% and specificity of 96% using eNose as compared to urine bacterial cultures. In conclusion: These findings strongly demonstrate the ability of our eNose to discriminate bacterial cultures and provides a proof of principle to use this method in urinanalysis of UTI.

Highlights

  • Urinary tract infection (UTI) is a condition where pathogen enters urinary system either by ascending via urethra or via hematological route and causes an infection that can range from mild cystitis to life-threatening pyelonephritis [1]

  • 80% of all uncomplicated UTIs are caused by gastrointestinal bacteria Escherichia coli, approximately 15% are caused by Staphylococcus saprophyticus, a bacterium commonly present in female genital tract [3]

  • In this study we demonstrate the ability of IMSbased electronic nose (eNose) to discriminate cultured urinary pathogens with high sensitivity and specificity

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Summary

Introduction

Urinary tract infection (UTI) is a condition where pathogen enters urinary system either by ascending via urethra or via hematological route and causes an infection that can range from mild cystitis to life-threatening pyelonephritis [1]. UTI is one of the most common infections in humans. It is associated with considerable economical costs [2]. 80% of all uncomplicated UTIs are caused by gastrointestinal bacteria Escherichia coli, approximately 15% are caused by Staphylococcus saprophyticus, a bacterium commonly present in female genital tract [3]. A complicated UTI occurs in a patient who has a predisposing factor such as diabetes or an abnormality in the urinary tract that lowers natural resistance and enables opportunistic infections. E. coli is the most common pathogen in this population as well, but the composition of other pathogens depends on the predisposing factor of the patient [3]

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