Utility, feasibility, and socio-demographic considerations in the diagnosis of bacterial RTI's by GC-IMS breath analysis
Trenton K. Stewart,
Emma Brodrick,
Matthew J. Reed,
Andrea M. Collins,
Emma Daulton,
Emily Adams,
Nicholas Feasey,
Libbe Ratcliffe,
Diane Exley,
Stacy Todd,
Nadja van Ginneken,
Amandip Sahota,
Graham Devereux,
E.M. Williams,
James A. Covington
Affiliations
Trenton K. Stewart
Warwick Medical School, University of Warwick, Coventry, UK; School of Engineering, University of Warwick, Coventry, UK; Corresponding author
Emma Brodrick
IMSPEX Diagnostics Ltd., Wales, UK
Matthew J. Reed
Emergency Medicine Research Group Edinburgh (EMERGE), Royal Infirmary of Edinburgh, Edinburgh, UK; Acute Care Edinburgh, Usher Institute, University of Edinburgh, Edinburgh, UK
Andrea M. Collins
Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Liverpool University Hospitals NHS Trust, Liverpool, UK; NIHR CRN Northwest Coast, Liverpool, UK
Emma Daulton
School of Engineering, University of Warwick, Coventry, UK
Emily Adams
Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
Nicholas Feasey
Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
Libbe Ratcliffe
Liverpool University Hospitals NHS Trust, Liverpool, UK
Diane Exley
Brownlow Health, Liverpool, UK
Stacy Todd
Liverpool University Hospitals NHS Trust, Liverpool, UK
Nadja van Ginneken
Brownlow Health, Liverpool, UK; Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
Amandip Sahota
Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
Graham Devereux
Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK; Liverpool University Hospitals NHS Trust, Liverpool, UK
E.M. Williams
University of South Wales, Newport, UK
James A. Covington
School of Engineering, University of Warwick, Coventry, UK
Summary: Diagnosis of respiratory tract infections (RTIs), especially in primary care, is typically made on clinical features and in the absence of quick and reliable diagnostic tests. Even in secondary care, where diagnostic microbiology facilities are available, these tests take 24–48 h to provide an indication of the etiology. This multicentre study used a portable gas chromatography-ion mobility spectrometer (GC-IMS) for the diagnosis of bacterial RTIs. Breath samples taken from 570 participants with 149 clinically validated bacterial and 421 non-bacterial RTIs were analyzed to distinguish bacterial from non-bacterial RTIs. Through the integration of a sparse logistic regression model, we identified a moderate diagnostic accuracy of 0.73 (95% CI 0 · 69, 0 · 77) alongside a sensitivity of 0 · 85 (95% CI 0 · 79, 0 · 91) and a specificity of 0 · 55 (95% CI 0 · 50, 0 · 60). The GC-IMS diagnostic device provides a promising outlook in distinguishing bacterial from non-bacterial RTIs and was also favorably viewed by participants.
