Electronic nose analysis of bronchoalveolar lavage fluid.
BACKGROUND
Electronic nose (E-nose) technology has been successfully used to diagnose a number of microbial infections. We have investigated the potential use of an E-nose for the diagnosis of ventilator-associated pneumonia (VAP) by detecting micro-organisms in bronchoalveolar lavage (BAL) fluid in a prospective comparative study of E-nose analysis and microbiology.


METHODS
BAL samples were collected using a blind technique from 44 patients following a minimum of 72 h mechanical ventilation. Control samples were collected from six patients mechanically ventilated on the intensive care unit (ICU) immediately following elective surgery. Quantitative microbiological culture and E-nose headspace analysis of the BAL samples were undertaken. Multivariate analysis was applied to correlate E-nose response with microbiological growth.


RESULTS
E-nose fingerprints correctly classified 77% of the BAL samples, with and without microbiological growth from patients not on antibiotics. Inclusion of patients on antibiotics resulted in 68% correct classification. Seventy per cent of isolates, cultured in the laboratory from the clinical samples, were accurately discriminated into four clinically significant groups.


CONCLUSIONS
E-nose technology can accurately discriminate between different microbial species in BAL samples from ventilated patients on ICU at risk of developing VAP with accuracy comparable with accepted microbiological techniques.
Humphreys
Lee
L
Biophotonics Research Unit, Gloucestershire Royal Hospital, Gloucester, UK.
Orme
Robert M L'E
RM
Moore
Philippa
P
Charaklias
Napoleon
N
Sahgal
Natasha
N
Pont
Neus Planas
NP
Magan
Naresh
N
Stone
Nicholas
N
Kendall
Catherine A
CA
D018893:Bronchoalveolar Lavage / Q000379:methods*; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis / Q000382:microbiology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity