Department of Pediatrics, Washington University School of Medicine , St. Louis, Missouri, USA.
Department of Pediatrics, Children's Hospital of Philadelphia , Philadelphia, Pennsylvania, USA.
mSphere. 2023 Oct 24;8(5):e0019423. doi: 10.1128/msphere.00194-23. Epub 2023 Oct 4.
Sore throat is one of the most common complaints encountered in the ambulatory clinical setting. Rapid, culture-independent diagnostic techniques that do not rely on pharyngeal swabs would be highly valuable as a point-of-care strategy to guide outpatient antibiotic treatment. Despite the promise of this approach, efforts to detect volatiles during oropharyngeal infection have yet been limited. In our research study, we sought to evaluate for specific bacterial volatile organic compounds (VOC) biomarkers in isolated cultures , in order to establish proof-of-concept prior to initial clinical studies of breath biomarkers. A particular challenge for the diagnosis of pharyngitis due to is the likelihood that many metabolites may be shared by and other related oropharyngeal colonizing bacterial species. Therefore, we evaluated whether sufficient metabolic differences are present, which distinguish the volatile metabolome of Group A streptococci from other streptococcal species that also colonize the respiratory mucosa, such as and . In this work, we identified 27 discriminatory VOCs (-values < 0.05), composed of aldehydes, alcohols, nitrogen-containing compounds, hydrocarbons, ketones, aromatic compounds, esters, ethers, and carboxylic acid. From this group of volatiles, we identify candidate biomarkers that distinguish from other species and establish highly produced VOCs that indicate the presence of , supporting future breath-based diagnostic testing for streptococcal pharyngitis. IMPORTANCE Acute pharyngitis accounts for approximately 15 million ambulatory care visits in the United States. The most common and important bacterial cause of pharyngitis is , accounting for 15%-30% of pediatric pharyngitis. Distinguishing between bacterial and viral pharyngitis is key to management in US practice. The culture of a specimen obtained by a throat swab is the standard laboratory procedure for the microbiologic confirmation of pharyngitis; however, this method is time-consuming, which delays appropriate treatment. If left untreated, pharyngitis may lead to local and distant complications. In this study, we characterized the volatile metabolomes of and other related oropharyngeal colonizing bacterial species. We identify candidate biomarkers that distinguish from other species and provide evidence to support future breath-based diagnostic testing for streptococcal pharyngitis.
喉咙痛是门诊临床环境中最常见的投诉之一。快速、不依赖咽拭子的、独立于培养的诊断技术,如果能作为一种床边策略来指导门诊抗生素治疗,将具有很高的价值。尽管这种方法很有前景,但在口咽感染期间检测挥发性物质的努力仍受到限制。在我们的研究中,我们试图在分离培养物中检测特定的细菌挥发性有机化合物 (VOC) 生物标志物,以便在最初的呼吸生物标志物临床研究之前建立概念验证。由于 引起的咽炎的诊断特别具有挑战性,因为许多代谢物可能与 和其他相关的口咽定植细菌物种共享。因此,我们评估了是否存在足够的代谢差异,这些差异可以区分 A 组链球菌的挥发性代谢组与其他也定植于呼吸道黏膜的链球菌物种,如 和 。在这项工作中,我们确定了 27 种有区别的 VOC(-值 < 0.05),由醛、醇、含氮化合物、碳氢化合物、酮、芳香族化合物、酯、醚和羧酸组成。在这组挥发物中,我们确定了可以区分 和其他物种的候选生物标志物,并确定了高度产生的 VOC,表明 的存在,支持未来基于呼吸的链球菌性咽炎的诊断测试。
重要性:急性咽炎占美国约 1500 万门诊就诊的原因。咽炎最常见和最重要的细菌病因是 ,占儿科咽炎的 15%-30%。区分细菌性和病毒性咽炎是美国实践中管理的关键。通过咽喉拭子获得的标本培养是微生物学确认咽炎的标准实验室程序;然而,这种方法耗时,会延迟适当的治疗。如果不治疗, 咽炎可能会导致局部和远处并发症。在这项研究中,我们描述了 和其他相关的口咽定植细菌物种的挥发性代谢组。我们确定了可以区分 和其他物种的候选生物标志物,并提供证据支持未来基于呼吸的链球菌性咽炎的诊断测试。
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