气味–为尿液分析增加了新的维度
Smell – Adding a New Dimension to Urinalysis气味–为尿液分析增加了新的维度
Eva H. Visser 1,*,Daan J.C. Berkhout 1,Jiwanjot Singh 1,Annemieke Vermeulen 2,Niloufar Ashtiani 3,Nanne K. de Boer 4,Joanna A.E. van Wijk 5,Tim G. de Meij 1 and Arend Bökenkamp 5 1 Department of Pediatric Gastro-Enterology, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands 2 Department of Pediatrics, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands 3 Department of Pediatrics, OLVG Oost, 1091 AC Amsterdam, The Netherlands 4 Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands 5 Department of Pediatric Nephrology, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands Author to whom correspondence should be addressed. Biosensors 2020, 10(5), 48; https://doi.org/10.3390/bios10050048 Received: 23 March 2020 / Revised: 30 April 2020 / Accepted: 3 May 2020 / Published: 5 May 2020
Abstract Background: Urinary tract infections (UTI) are among the most common infections in children. The primary tool to detect UTI is dipstick urinalysis; however, this has limited sensitivity and specificity. Therefore, urine culture has to be performed to confirm a UTI. Urinary volatile organic compounds (VOC) may serve as potential biomarker for diagnosing UTI. Previous studies on urinary VOCs focused on detection of UTI in a general population; therefore, this proof-of-principle study was set up in a clinical high-risk pediatric population. Methods: This study was performed at a tertiary nephro-urological clinic. Patients included were 0–18 years, clinically suspected of a UTI, and had abnormal urinalysis. Urine samples were divided into four groups, i.e., urine without bacterial growth, contamination, colonization, and UTI. VOC analysis was performed using an electronic nose (eNose) (Cyranose 320®) and VOC profiles of subgroups were compared. Results: Urinary VOC analysis discriminated between UTI and non-UTI samples (AUC 0.70; p = 0.048; sensitivity 0.67, specificity 0.70). The diagnostic accuracy of VOCs improved when comparing urine without bacterial growth versus with UTI (AUC 0.80; p = 0.009, sensitivity 0.79, specificity 0.75). Conclusions: In an intention-to-diagnose high-risk pediatric population, UTI could be discriminated from non-UTI by VOC profiling, using an eNose. Since eNose can be used as bed-side test, these results suggest that urinary VOC analysis may serve as an adjuvant in the diagnostic work-up of UTI in children.
背景：尿路感染是儿童见的感染之一。检测尿路感染的主要工具是试纸尿检，但其敏感性和特异性有限。因此，必须进行尿培养以确认尿路感染。尿挥发性有机物（VOC）可作为诊断尿路感染的潜在生物标志物。以往关于尿中挥发性有机物的研究主要集中在检测普通人群中的尿路感染，因此，本研究是在临床高危儿童人群中进行的。方法：本研究在第三肾泌尿外科门诊进行。患者年龄0-18岁，临床怀疑有尿路感染，尿检异常。尿样分为4组，即无细菌生长、污染、定植和尿路感染的尿样。使用电子鼻（eNose）（Cyranose 320）进行VOC分析，并比较各亚组的VOC分布。结果：尿VOC分析可区分尿路感染和非尿路感染（AUC 0.70，p=0.048，灵敏度0.67，特异性0.70）。将无细菌生长的尿液与尿路感染的尿液进行比较，VOCs的诊断准确率提高（AUC 0.80；p=0.009，灵敏度0.79，特异性0.75）。结论：在诊断高危儿童人群时，可通过VOC谱和enos来区分尿路感染和非尿路感染。由于enos可作为儿童尿路感染的床旁检查，提示尿VOC分析可作为儿童尿路感染诊断的辅助手段。
Keywords: urinary tract infection; electronic nose; bacterial growth culture; volatile organic compounds
关键词：尿路感染；电子鼻；细菌生长培养；挥发性有机物
页:
[1]