The Potential of Fecal Volatile Organic Compound Analysis for the Early Diagnosis of Late-Onset Sepsis in Preterm Infants: A Narrative Review

被引:1
作者
de Kroon, Rimke R. [1 ,2 ]
Frerichs, Nina M. [1 ,2 ]
Struys, Eduard A. [3 ]
de Boer, Nanne K. [4 ]
de Meij, Tim G. J. [1 ]
Niemarkt, Hendrik J. [5 ,6 ]
机构
[1] Univ Amsterdam, Amsterdam Univ Med Ctr, Emma Childrens Hosp, Dept Pediat Gastroenterol,Amsterdam Gastroenterol, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands
[2] Univ Amsterdam, Amsterdam Univ Med Ctr, Amsterdam Reprod & Dev Res Inst, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands
[3] Univ Amsterdam, Dept Lab Med, Locat AMC, Med Ctr, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands
[4] Vrije Univ Amsterdam, Amsterdam Univ, Amsterdam Gastroenterol Endocrinol Metab Res Inst, Dept Gastroenterol & Hepatol,Med Ctr, De Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands
[5] Maxima Med Ctr, Dept Neonatol, De Run 4600, NL-5504 DB Veldhoven, Netherlands
[6] Eindhoven Univ Technol, Dept Elect Engn, TU Eindhoven, Postbus 513, NL-5600 MB Eindhoven, Netherlands
关键词
neonatology; preterm infants; late-onset sepsis; volatile organic compounds; biomarker; detection; non-invasive diagnostics; electronic nose; intestinal microbiota; EMPIRICAL ANTIBIOTIC-TREATMENT; NECROTIZING ENTEROCOLITIS; BRONCHOPULMONARY DYSPLASIA; MASS-SPECTROMETRY; METABOLITES; INFECTION; IMPACT; RISK; BORN; MS;
D O I
10.3390/s24103162
中图分类号
O65 [分析化学];
学科分类号
070302 ; 081704 ;
摘要
Early diagnosis and treatment of late-onset sepsis (LOS) is crucial for survival, but challenging. Intestinal microbiota and metabolome alterations precede the clinical onset of LOS, and the preterm gut is considered an important source of bacterial pathogens. Fecal volatile organic compounds (VOCs), formed by physiologic and pathophysiologic metabolic processes in the preterm gut, reflect a complex interplay between the human host, the environment, and microbiota. Disease-associated fecal VOCs can be detected with an array of devices with various potential for the development of a point-of-care test (POCT) for preclinical LOS detection. While characteristic VOCs for common LOS pathogens have been described, their VOC profiles often overlap with other pathogens due to similarities in metabolic pathways, hampering the construction of species-specific profiles. Clinical studies have, however, successfully discriminated LOS patients from healthy individuals using fecal VOC analysis with the highest predictive value for Gram-negative pathogens. This review discusses the current advancements in the development of a non-invasive fecal VOC-based POCT for early diagnosis of LOS, which may potentially provide opportunities for early intervention and targeted treatment and could improve clinical neonatal outcomes. Identification of confounding variables impacting VOC synthesis, selection of an optimal detection device, and development of standardized sampling protocols will allow for the development of a novel POCT in the near future.
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页数:17
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