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Stool volatile organic compounds identified patients with C. difficile-associated diarrhea
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WASHINGTON, D.C. — Stool volatile organic compound analysis differentiated between patients with and without Clostridium difficile-associated diarrhea, according to data presented at ICAAC 2014.
Currently there is “a delay of 3-5 days between the onset of symptoms and diagnosis of C. diff,” because of delays in ordering the stool sample, waiting for the patient to produce the stool sample, and turnaround time once it reaches the microbiology lab, Sophia Koo, MD, of the Brigham and Women’s Hospital and Harvard Medical School, told Healio.com/Gastroenterology. “A lot of the transmission might happen during that period of time between the onset of symptoms and diagnosis, so the idea was to develop a way to assess the volatile metabolome of the microbiome of people with toxigenic C. diff infection.”
Sophia Koo
To determine a stool volatile organic compound (VOC) profile for patients with C. diff-associated diarrhea (CDAD), Koo and colleagues collected and analyzed specimens from 69 patients (median age, 58 years; 39% women) with suspected CDAD from November 2013 to February 2014. They determined VOCs and the presence or absence of C. diff toxins, and subsequently established a set of VOCs predictive of CDAD.
Twenty-four patients were diagnosed with CDAD, and 589 distinct volatile metabolites were identified in all samples (median VOCS per patient, 87). The CDAD-predictive VOC profile included ethyl acetate, acetic acid, 4-methyl-1-pentanol, and 2,6-dimethylnonane (ROC AUC=0.8).
“We identified a profile that has fairly good sensitivity and specificity in discriminating people with and without C. diff,” Koo said. “The ultimate idea would be to use this profile to screen [patients] in order to catch C. diff earlier … and try to isolate these patients and treat them earlier as well.”
“While this work requires further validation, stool VOC analysis may have a role in the diagnosis of CDAD, particularly if adapted to a rapid bedside point-of-care detection platform,” the researchers concluded. – by Adam Leitenberger
For more information:
Koo S. Abstract D-203. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 5-9, 2014; Washington, D.C.
Disclosure: The researchers report no relevant financial disclosures.