Exhaled Breath Analysis Detects the Clearance of Staphylococcus aureus from the Airways of Children with Cystic Fibrosis
Aim: To investigate whether the clearance of SA from the airways of patients with a previous airway culture positive for SA can also be detected using the eNose.
Take home message: eNose technology offers a non-invasive, reliable method for detecting and monitoring Staphylococcus aureus infection in children with cystic fibrosis, potentially reducing the need for invasive testing and enabling better infection management.
Introduction
This study explores the potential of electronic nose (eNose) technology to detect changes in lung infection status in children with cystic fibrosis (CF), specifically focusing on Staphylococcus aureus (SA). Current methods for monitoring lung infections in CF patients rely on invasive samples, which are challenging to obtain, especially in children. eNose technology analyzes exhaled volatile organic compounds (VOCs), offering a non-invasive alternative for assessing infection status.
Methods
This prospective study followed 72 children with CF at The Hospital for Sick Children in Toronto. Exhaled breath samples were collected using the SpiroNose® during routine clinic visits, and the VOC data were analyzed using the BreathBase®,platform. Patients were categorized into three groups: no SA detected at both visits, persistent SA infection, and SA clearance between visits. Data analysis included linear discriminant analysis and receiver operating characteristic (ROC) curve evaluation to assess the diagnostic accuracy of the eNose.
Results
The eNose effectively distinguished SA-positive from SA-negative breath profiles at baseline (AUC 0.757, p < 0.001). Significant changes in VOC signals were detected in patients who cleared the SA infection (Group 3), particularly in sensors S4, S6, and S7 (p-values: 0.047, 0.014, 0.014). No significant breath profile changes were observed in patients with stable infection status (SA-positive or SA-negative) between visits. The breath profiles were consistent regardless of antibiotic treatment, indicating that eNose technology could detect infection clearance independent of therapeutic interventions.
Discussion
The findings suggest that eNose technology is a non-invasive tool for monitoring SA infection status in children with CF. The ability to detect infection clearance using VOC profiles could enhance current clinical practices, reducing the need for invasive sampling. This technology offers a quick, real-time assessment during routine clinic visits and may be beneficial for patients on CFTR modulator therapy, where sputum production is limited. Future studies should explore the broader application of eNose technology in tracking treatment response and managing chronic infections in CF patients.
This research highlights the potential role of eNose as a point-of-care diagnostic tool, improving infection monitoring and potentially aiding in personalized treatment strategies for children with cystic fibrosis.
