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A breath fungal secondary metabolite signature to diagnose invasive aspergillosis. | LitMetric

AI Article Synopsis

  • Invasive aspergillosis (IA) is a serious infection mainly affecting immunocompromised patients, making accurate diagnosis crucial for treatment.
  • Researchers used thermal desorption-gas chromatography/mass spectrometry to analyze volatile metabolites from Aspergillus fumigatus, the primary causative agent of IA, and collected breath samples from 64 patients suspected of having fungal pneumonia.
  • Detection of specific volatile metabolites in these breath samples successfully distinguished IA patients with 94% sensitivity and 93% specificity, showing that this method could be a noninvasive way to identify the exact cause of pneumonia.

Article Abstract

Background: Invasive aspergillosis (IA) remains a leading cause of mortality in immunocompromised patients, in part due to the difficulty of diagnosing this infection.

Methods: Using thermal desorption-gas chromatography/mass spectrometry, we characterized the in vitro volatile metabolite profile of Aspergillus fumigatus, the most common cause of IA, and other pathogenic aspergilli. We prospectively collected breath samples from patients with suspected invasive fungal pneumonia from 2011 to 2013, and assessed whether we could discriminate patients with proven or probable IA from patients without aspergillosis, as determined by European Organization for Research and Treatment of Cancer/Mycoses Study Group consensus definitions, by direct detection of fungal volatile metabolites in these breath samples.

Results: The monoterpenes camphene, α- and β-pinene, and limonene, and the sesquiterpene compounds α- and β-trans-bergamotene were distinctive volatile metabolites of A. fumigatus in vitro, distinguishing it from other pathogenic aspergilli. Of 64 patients with suspected invasive fungal pneumonia based on host risk factors, clinical symptoms, and radiologic findings, 34 were diagnosed with IA, whereas 30 were ultimately diagnosed with other causes of pneumonia, including other invasive mycoses. Detection of α-trans-bergamotene, β-trans-bergamotene, a β-vatirenene-like sesquiterpene, or trans-geranylacetone identified IA patients with 94% sensitivity (95% confidence interval [CI], 81%-98%) and 93% specificity (95% CI, 79%-98%).

Conclusions: In patients with suspected fungal pneumonia, an Aspergillus secondary metabolite signature in breath can identify individuals with IA. These results provide proof-of-concept that direct detection of exogenous fungal metabolites in breath can be used as a novel, noninvasive, pathogen-specific approach to identifying the precise microbial cause of pneumonia.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311178PMC
http://dx.doi.org/10.1093/cid/ciu725DOI Listing

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