Highlights
- •Cystic fibrosis lung infection with Staphylococcus aureus can be detected in breath by electronic nose.
- •The electronic nose can distinguish between Staphylococcus aureus and Pseudomonas aeruginosa lung infection.
- •Breath profiles of children with cystic fibrosis and no infection of the lung are different from those of healthy children.
- •CFTR modulator therapy may not normalize the breath profile of treated individuals with cystic fibrosis.
Abstract
Background
An electronic nose (eNose) can be used to detect volatile organic compounds (VOCs).
Exhaled breath contains numerous VOCs and individuals’ VOCs mixtures create distinct
breath profiles. Previous reports have shown that eNose can detect lung infections.
Whether eNose can detect Staphylococcus aureus airway infections in breath of children
with cystic fibrosis (CF) is currently unclear.
Methods
In this cross-sectional observational study, a cloud-connected eNose was used for
breath profile analysis of clinically stable paediatric CF patients with airway microbiology
cultures positive or negative for CF pathogens. Data-analysis involved advanced signal
processing, ambient correction and statistics based on linear discriminant and receiver
operating characteristics (ROC) analyses.
Results
Breath profiles from 100 children with CF (median predicted FEV1 91%) were obtained and analysed. CF patients with positive airway cultures for any
CF pathogen were distinguishable from no CF pathogens (no growth or usual respiratory
flora) with accuracy of 79.0% (AUC-ROC 0.791; 95% CI: 0.669–0.913) and between patients
positive for Staphylococcus aureus (SA) only and no CF pathogen with accuracy of 74.0% (AUC-ROC 0.797; 95% CI: 0.698–0.896).
Similar differences were seen for Pseudomonas aeruginosa (PA) infection vs no CF pathogens (78.0% accuracy, AUC-ROC 0.876, 95% CI: 0.794–0.958).
SA- and PA-specific signatures were driven by different sensors in the SpiroNose suggesting
pathogen-specific breath signatures.
Conclusions
Breath profiles of CF patients with SA in airway cultures are distinct from those
with no infection or PA infection, suggesting the utility of eNose technology in the
detection of this early CF pathogen in children with CF.
Keywords
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Article info
Publication history
Published online: February 25, 2023
Accepted:
February 20,
2023
Received in revised form:
December 23,
2022
Received:
September 26,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
