Faecal volatile biomarkers of Clostridium difficile infection

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dc.contributor.authorPatel, Mitesh
dc.contributor.authorFowler, Dawn
dc.contributor.authorSizer, Jeremy
dc.contributor.authorWalton, Christopher
dc.date.accessioned2019-04-18T14:11:43Z
dc.date.available2019-04-18T14:11:43Z
dc.date.issued2019-04-15
dc.description.abstractCare of patients with potential CDI can involve isolation and use of antibiotics, often before a definitive diagnosis is available, impacting healthcare resource and contributing to antibiotic resistance. There is anecdotal evidence that the faeces of CDI patients have a distinctive odour, while it is well-established that changes in the gut microbiota are associated with changes in the volatile organic compounds (VOC) produced. A total of twenty-four candidate volatile biomarkers were identified from a review of the literature including in vitro, animal and human studies. Using thermal desorption-gas chromatography-time-of flight mass spectrometry (TD-GC-ToFMS), VOC emission rates were determined on stored frozen stool samples from 53 CDI-positive and 53 CDI-negative patients with unexplained diarrhoea which had previously been diagnosed using enzymatic and nucleic acid amplification tests. Sample preparation was limited to placement of a subsample in an appropriate container. Compounds exhibiting a statistically significant difference (p < 0.05) in emission rate between the CDI-positive and–negative groups and a corresponding area under the receiver-operator characteristic curve (ROC) >0.7 were considered potentially indicative of CDI. Seven compounds were so identified: propan-1-ol (ROC 0.75), 3-methylbutanal (ROC 0.84), ethyl propionate (ROC 0.81), hexanoic acid (ROC 0.73), 4-methylphenol (ROC 0.81), dodecane (ROC 0.80) and indole (ROC 0.85). A number of potential volatile biomarkers of CDI can be sampled rapidly and with little prior preparation from faecal samples of patients with diarrhoea. Of these 4-methylphenol (p-cresol) is of particular interest as it has been anecdotally linked to CDI and is closely related to the biology and virulence of Clostridium difficile. This approach shows promise for the rapid, point-of-care diagnosis of CDI with good sensitivity and specificity.en_UK
dc.identifier.citationPatel M, Fowler D, Sizer J, Walton C. (2019) Faecal volatile biomarkers of Clostridium difficile infection. PLoS One, Volume 14, Issue 4, 2019, Article number e0215256en_UK
dc.identifier.cris23366932
dc.identifier.issn1932-6203
dc.identifier.urihttps://doi.org/10.1371/journal.pone.0215256
dc.identifier.urihttp://dspace.lib.cranfield.ac.uk/handle/1826/14099
dc.language.isoenen_UK
dc.publisherPublic Library of Scienceen_UK
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.titleFaecal volatile biomarkers of Clostridium difficile infectionen_UK
dc.typeArticleen_UK

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