title: Broad identification of bacterial type in urinary tract infection using (1)h NMR spectroscopy.
abstract: To address the shortcomings of urine culture for the rapid identification of urinary tract infection (UTI), we applied (1)H-nuclear magnetic resonance (NMR) spectroscopy as a surrogate method for fast screening of microorganisms. Study includes 682 urine samples from suspected UTI patients, 50 healthy volunteers, and commercially available standard strains of gram negative bacilli (GNB) (Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia, Enterobacter, Acinetobacter, Proteus mirabilis, Citrobacter frundii) and gram positive cocci (GPC) (Enterococcus faecalis, Streptococcus group B, Staphylococcus saprophyticus). Acetate, lactate, ethanol, succinate, creatinine, trimethylamine (TMA), citrate, trimethylamin-N-oxide, glycine, urea, and hippurate were measured by (1)H NMR spectroscopy. All urine specimens were evaluated with culture method. Multivariate discriminant function analysis (DFA) reveals that acetate, lactate, succinate, and formate were able to differentiate, with high accuracy (99.5%), healthy controls from UTI patients. This statistical analysis was also able to classify GNB to GPC infected urine samples with high accuracy (96%). This technique appears to be a promising, rapid, and noninvasive approach to probing GNB and GPC infected urine specimens with its distinguishing metabolic profile. The determination of infection will be very important for rapidly and efficiently measuring the efficacy of a tailored treatment, leading to prompt and appropriate care of UTI patients.
authors.affiliation: Centre of Biomedical Magnetic Resonance, Sanjay Gandhi Postgraduate Institute of Medical Sciences , Raebareli Road, Lucknow 226 014, India. ashishg24@yahoo.co.in
authors.forename: Ashish
authors.initials: A
authors.lastname: Gupta
authors.forename: Mayank
authors.initials: M
authors.lastname: Dwivedi
authors.forename: Abbas Ali
authors.initials: AA
authors.lastname: Mahdi
authors.forename: Chunni Lal
authors.initials: CL
authors.lastname: Khetrapal
authors.forename: Mahendra
authors.initials: M
authors.lastname: Bhandari
mesh_terms: D000328:Adult; D019540:Area Under Curve; D016022:Case-Control Studies; D003470:Culture Media / Q000737:chemistry; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification / Q000378:metabolism; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000382:microbiology* / Q000652:urine; D006094:Gram-Positive Bacteria / Q000302:isolation & purification / Q000378:metabolism; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000382:microbiology* / Q000652:urine; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D055442:Metabolome; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D016482:Urinalysis / Q000379:methods; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000382:microbiology* / Q000652:urine; D055815:Young Adult
chemical_list: D003470:Culture Media