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- Title
Late-onset Sepsis in Preterm Infants Can Be Detected Preclinically by Fecal Volatile Organic Compound Analysis: A Prospective, Multicenter Cohort Study.
- Authors
Berkhout, Daniel J C; Keulen, Britt J van; Niemarkt, Hendrik J; Bessem, Jet R; Boode, Willem P de; Cossey, Veerle; Hoogenes, Neil; Hulzebos, Christiaan V; Klaver, Ellen; Andriessen, Peter; Kaam, Anton H van; Kramer, Boris W; Lingen, Richard A van; Schouten, Aaron; Goudoever, Johannes B van; Vijlbrief, Daniel C; Weissenbruch, Mirjam M van; Wicaksono, Alfian N; Covington, James A; Benninga, Marc A
- Abstract
Background The intestinal microbiota has increasingly been considered to play a role in the etiology of late-onset sepsis (LOS). We hypothesize that early alterations in fecal volatile organic compounds (VOCs), reflecting intestinal microbiota composition and function, allow for discrimination between infants developing LOS and controls in a preclinical stage. Methods In 9 neonatal intensive care units in the Netherlands and Belgium, fecal samples of preterm infants born at a gestational age ≤30 weeks were collected daily, up to the postnatal age of 28 days. Fecal VOC were measured by high-field asymmetric waveform ion mobility spectrometry (FAIMS). VOC profiles of LOS infants, up to 3 days prior to clinical LOS onset, were compared with profiles from matched controls. Results In total, 843 preterm born infants (gestational age ≤30 weeks) were included. From 127 LOS cases and 127 matched controls, fecal samples were analyzed by means of FAIMS. Fecal VOCs allowed for preclinical discrimination between LOS and control infants. Focusing on individual pathogens, fecal VOCs differed significantly between LOS cases and controls at all predefined time points. Highest accuracy rates were obtained for sepsis caused by Escherichia coli, followed by sepsis caused by Staphylococcus aureus and Staphylococcus epidermidis. Conclusions Fecal VOC analysis allowed for preclinical discrimination between infants developing LOS and matched controls. Early detection of LOS may provide clinicians a window of opportunity for timely initiation of individualized therapeutic strategies aimed at prevention of sepsis, possibly improving LOS-related morbidity and mortality.
- Subjects
BELGIUM; NETHERLANDS; SEPTICEMIA prevention; FECAL analysis; ORGANIC compound analysis; AGE factors in disease; DISEASES; ESCHERICHIA coli; GESTATIONAL age; PREMATURE infants; LONGITUDINAL method; MEDICAL cooperation; MEDICAL personnel; NEONATAL intensive care; PUERPERIUM; RESEARCH; RESEARCH evaluation; SEPSIS; SPECTRUM analysis; STAPHYLOCOCCAL diseases; GUT microbiome; NEONATAL intensive care units; EARLY diagnosis; CHILDREN; DIAGNOSIS
- Publication
Clinical Infectious Diseases, 2019, Vol 68, Issue 1, p70
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciy383