| Summary: | <p>Abstract</p> <p>Background</p> <p><it>Pseudomonas aeruginosa </it>infections are associated with progressive life threatening decline of lung function in cystic fibrosis sufferers. Growth of <it>Ps. aeruginosa </it>releases a "grape-like" odour that has been identified as the microbial volatile organic compound 2-aminoacetophenone (2-AA).</p> <p>Methods</p> <p>We investigated 2-AA for its specificity to <it>Ps. aeruginosa </it>and its suitability as a potential breath biomarker of colonisation or infection by Solid Phase Micro Extraction and Gas Chromatography-Mass Spectrometry (GC/MS).</p> <p>Results</p> <p>Cultures of 20 clinical strains of <it>Ps. aeruginosa </it>but not other respiratory pathogens had high concentrations of 2-AA in the head space of <it>in vitro </it>cultures when analysed by GC/MS. 2-AA was stable for 6 hours in deactivated glass sampling bulbs but was not stable in Tedlar<sup>® </sup>bags. Optimisation of GC/MS allowed detection levels of 2-AA to low pico mol/mol range in breath. The 2-AA was detected in a significantly higher proportion of subjects colonised with <it>Ps. aeruginosa </it>15/16 (93.7%) than both the healthy controls 5/17 (29%) (p < 0.0002) and CF patients not colonised with <it>Ps. aeruginosa </it>4/13(30.7%) (p < 0.001). The sensitivity and specificity of the 2-AA breath test compared to isolation of <it>Ps. aeruginosa </it>in sputum and/or BALF was 93.8% (95% CI, 67-99) and 69.2% (95% CI, 38-89) respectively. The peak integration values for 2-AA analysis in the breath samples were significantly higher in <it>Ps. aeruginosa </it>colonised subjects (median 242, range 0-1243) than the healthy controls (median 0, range 0-161; p < 0.001) and CF subjects not colonised with <it>Ps. aeruginosa </it>(median 0, range 0-287; p < 0.003)</p> <p>Conclusions</p> <p>Our results report 2-AA as a promising breath biomarker for the detection of <it>Ps. aeruginosa </it>infections in the cystic fibrosis lung.</p>
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