AIMS: A novel method has been developed that allows successful differentiation between Clostridium difficile culture-positive and culture-negative stool samples based on volatile organic compound (VOC) evolution and detection by headspace solid-phase microextraction coupled with gas chromatography mass spectrometry (HS-SPME-GC-MS). METHODS AND RESULTS: The method is based on the activation of p-hydroxyphenylacetate decarboxylase produced by Cl. difficile and the detection of a specific VOC, that is 2-fluoro-4-methylphenol from an enzyme substrate. In addition, other VOCs were good indicators for Cl. difficile, that is isocaproic acid and p-cresol, although they could not be used alone for identification purposes. One hundred stool samples were tested, of which 77 were positive by culture. Detection using HS-SPME-GC-MS allowed confirmation of the presence of Cl. difficile within 18 h with a sensitivity and specificity of 83·1 and 100%, respectively. CONCLUSIONS: It is recommended that this new approach could be used alongside conventional methods for Cl. difficile detection, including toxin detection methods, which would allow any false-negative results to be eliminated. SIGNIFICANCE AND IMPACT OF THE STUDY: The ability to identify Cl. difficile-positive stool samples by the analysis of VOCs could allow the development of a VOC detection device which could allow rapid diagnosis of disease and hence prompt treatment with appropriate antibiotics.
AIMS: A novel method has been developed that allows successful differentiation between Clostridium difficile culture-positive and culture-negative stool samples based on volatile organic compound (VOC) evolution and detection by headspace solid-phase microextraction coupled with gas chromatography mass spectrometry (HS-SPME-GC-MS). METHODS AND RESULTS: The method is based on the activation of p-hydroxyphenylacetate decarboxylase produced by Cl. difficile and the detection of a specific VOC, that is 2-fluoro-4-methylphenol from an enzyme substrate. In addition, other VOCs were good indicators for Cl. difficile, that is isocaproic acid and p-cresol, although they could not be used alone for identification purposes. One hundred stool samples were tested, of which 77 were positive by culture. Detection using HS-SPME-GC-MS allowed confirmation of the presence of Cl. difficile within 18 h with a sensitivity and specificity of 83·1 and 100%, respectively. CONCLUSIONS: It is recommended that this new approach could be used alongside conventional methods for Cl. difficile detection, including toxin detection methods, which would allow any false-negative results to be eliminated. SIGNIFICANCE AND IMPACT OF THE STUDY: The ability to identify Cl. difficile-positive stool samples by the analysis of VOCs could allow the development of a VOC detection device which could allow rapid diagnosis of disease and hence prompt treatment with appropriate antibiotics.
Authors: Marije K Bomers; Frederik P Menke; Richard S Savage; Christina M J E Vandenbroucke-Grauls; Michiel A van Agtmael; James A Covington; Yvo M Smulders Journal: Am J Gastroenterol Date: 2015-03-31 Impact factor: 10.864
Authors: Daniel J C Berkhout; Marc A Benninga; Ruby M van Stein; Paul Brinkman; Hendrik J Niemarkt; Nanne K H de Boer; Tim G J de Meij Journal: Sensors (Basel) Date: 2016-11-23 Impact factor: 3.576
Authors: Maciej Milanowski; Paweł Pomastowski; Viorica Railean-Plugaru; Katarzyna Rafińska; Tomasz Ligor; Bogusław Buszewski Journal: PLoS One Date: 2017-03-31 Impact factor: 3.240
Authors: Andreas Bergmann; Phillip Trefz; Sina Fischer; Klaus Klepik; Gudrun Walter; Markus Steffens; Mario Ziller; Jochen K Schubert; Petra Reinhold; Heike Köhler; Wolfram Miekisch Journal: PLoS One Date: 2015-04-27 Impact factor: 3.240