Smell – Adding a New Dimension to Urinalysis
氣味–為尿液分析增加了新的維度
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/bios
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：尿路感染是兒童見的感染之一。檢測尿路感染的主要工具是試紙尿檢，但其敏感性和特異性有限。因此，必須進(jìn)行尿培養(yǎng)以確認(rèn)尿路感染。尿揮發(fā)性有機(jī)物(VOC)可作為診斷尿路感染的潛在生物標(biāo)志物。以往關(guān)于尿中揮發(fā)性有機(jī)物的研究主要集中在檢測普通人群中的尿路感染，因此，本研究是在臨床高危兒童人群中進(jìn)行的。方法：本研究在第三腎泌尿外科門診進(jìn)行。患者年齡0-18歲，臨床懷疑有尿路感染，尿檢異常。尿樣分為4組，即無細(xì)菌生長、污染、定植和尿路感染的尿樣。使用電子鼻(eNose)(Cyranose 320)進(jìn)行VOC分析，并比較各亞組的VOC分布。結(jié)果：尿VOC分析可區(qū)分尿路感染和非尿路感染(AUC 0.70，p=0.048，靈敏度0.67，特異性0.70)。將無細(xì)菌生長的尿液與尿路感染的尿液進(jìn)行比較，VOCs的診斷準(zhǔn)確率提高(AUC 0.80；p=0.009，靈敏度0.79，特異性0.75)。結(jié)論：在診斷高危兒童人群時，可通過VOC譜和enos來區(qū)分尿路感染和非尿路感染。由于enos可作為兒童尿路感染的床旁檢查，提示尿VOC分析可作為兒童尿路感染診斷的輔助手段。
Keywords:urinary tract infection; electronic nose; bacterial growth culture; volatile organic compounds
關(guān)鍵詞：尿路感染；電子鼻；細(xì)菌生長培養(yǎng)；揮發(fā)性有機(jī)物
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