- •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.
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.
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.
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.
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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Cystic Fibrosis
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The future of cystic fibrosis care: a global perspective.Lancet Respir Med. 2020; 8: 65-124
- Staphylococcus aureus in early cystic fibrosis lung disease.Pediatr Pulmonol. 2013; 48: 1151-1159
- Early pulmonary inflammation in infants with cystic fibrosis.Am J Respir Crit Care Med. 1995; 151: 1075-1082
- Safety of bronchoalveolar lavage in young children with cystic fibrosis.Pediatr Pulmonol. 2008; 43: 965-972
- Sputum induction in routine clinical care of children with cystic fibrosis.J Pediatr. 2010; 157: 1006-1011
De Vries R., Dagelet Y.W., Spoor P., et al. Clinical and inflammatory phenotyping by breathomics in chronic airway diseases irrespective of the diagnostic label. Eur Respir J; 51.
- Advances in electronic-nose technologies for the detection of volatile biomarker metabolites in the human breath.Metabolites. 2015; 5: 140-163
- Exhaled molecular fingerprinting in diagnosis and monitoring: validating volatile promises.Trends Mol Med. 2015; 21: 633-644
- Exhaled air molecular profiling in relation to inflammatory subtype and activity in COPD.Eur Respir J. 2011; 38: 1301-1309
- Integration of electronic nose technology with spirometry: validation of a new approach for exhaled breath analysis.J Breath Res. 2015; 9046001
- Electronic nose technology in respiratory diseases.Lung. 2017; 195: 157-165
- Potential of the electronic nose for the detection of respiratory diseases with and without infection.Int J Mol Sci. 2020; 21: 9416
- eNose breathprints as composite biomarker for real-time phenotyping of complex respiratory diseases.J Allergy Clin Immunol. 2020; 146: 995-996
- Increased day-to-day fluctuations in exhaled breath profiles after a rhinovirus challenge in asthma.Allergy. 2021; 76: 2488-2499
- Exhaled molecular profiles in the assessment of cystic fibrosis and primary ciliary dyskinesia.J Cyst Fibros. 2013; 12: 454-460
- Feasibility and diagnostic accuracy of an electronic nose in children with asthma and cystic fibrosis.J Breath Res. 2019; 13036009
- Detection of Staphylococcus aureus in cystic fibrosis patients using breath VOC profiles.J Breath Res. 2016; 10046014
- Exhaled breath analysis using electronic nose in cystic fibrosis and primary ciliary dyskinesia patients with chronic pulmonary infections.PLoS ONE. 2014; 9e115584
- Electronic nose technology for detection of invasive pulmonary aspergillosis in prolonged chemotherapy-induced neutropenia: a proof-of-principle study.J Clin Microbiol. 2013; 51: 1490-1495
- Molecular analysis of volatile metabolites released specifically by Staphylococcus aureus and Pseudomonas aeruginosa.BMC Microbiol. 2012; 12: 1-16
- Cystic Fibrosis Foundation Consensus Conference on Infection Control Participants. Infection control recommendations for patients with cystic fibrosis: microbiology, important pathogens, and infection control practices to prevent patient-to-patient transmission.Am J Infect Control. 2003; 31: S1-S62
- Diagnosis of pneumonia with an electronic nose: correlation of vapor signature with chest computed tomography scan findings.Laryngoscope. 2004; 114: 1701-1705
- Antimicrobial treatment of Staphylococcus aureus in patients with cystic fibrosis.Front Pharmacol. 2019; 849
- Early respiratory bacterial detection and antistaphylococcal antibiotic prophylaxis in young children with cystic fibrosis.Ann Am Thorac Soc. 2018; 15: 42-48
- Throat swabs and sputum culture as predictors of P. aeruginosa or S. aureus lung colonization in adult cystic fibrosis patients.PLoS ONE. 2016; 11e0164232
- Risk factors for mortality before age 18 years in cystic fibrosis.Pediatr Pulmonol. 2017; 52: 909-915
- Volatile metabolites of pathogens: a systematic review.PLoS Pathog. 2013; 9e1003311
- Metabolomics of volatile organic compounds in cystic fibrosis patients and controls.Pediatr Res. 2010; 68: 75-80
- Inflammatory responses to individual microorganisms in the lungs of children with cystic fibrosis.Clin Infect Dis. 2011; 53 (Epub ahead of print)https://doi.org/10.1093/cid/cir399
- eNose technology for detection of pseudomonas aeruginosa infection in cystic fibrosis patients.D34. cystic fibrosis and BRONCHIECTASIS: clinical and mechanistic studies. American Thoracic Society, 2019: A6181 (–A6181)
- A CFTR potentiator in patients with cystic fibrosis and the G551D mutation.N Engl J Med. 2011; 365: 1663-1672
- A CFTR corrector (lumacaftor) and a CFTR potentiator (ivacaftor) for treatment of patients with cystic fibrosis who have a phe508del CFTR mutation: a phase 2 randomised controlled trial.Lancet Respir Med. 2014; 2: 527-538
- Sustained benefit from ivacaftor demonstrated by combining clinical trial and cystic fibrosis patient registry data.Am J Respir Crit Care Med. 2015; 192: 836-842
- Restoring cystic fibrosis transmembrane conductance regulator function reduces airway bacteria and inflammation in people with cystic fibrosis and chronic lung infections.Am J Respir Crit Care Med. 2017; 195: 1617-1628
- Bronchoscopy in cystic fibrosis infants diagnosed by newborn screening.Pediatr Pulmonol. 2011; 46: 696-700
- Interlobar differences in bronchoalveolar lavage fluid from children with cystic fibrosis.Eur Respir J. 2001; 17: 281-286
Published online: February 25, 2023
Accepted: February 20, 2023
Received in revised form: December 23, 2022
Received: September 26, 2022
Publication stageIn Press Corrected Proof
© 2023 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.