Metabolomic Profiling of Infectious Parapneumonic Effusions Reveals Biomarkers for Guiding Management of Children with Streptococcus pneumoniae Pneumonia.
Metabolic markers in biofluids represent an attractive tool for guiding clinical management. The aim of this study was to identify metabolic mechanisms during the progress of pleural infection in children with Streptococcus pneumoniae pneumonia. Forty children diagnosed with pneumococcal pneumonia were enrolled and analysis of pleural fluid metabolites categorized by complicated parapneumonic effusions (CPE) and non-CPE was assessed by using (1)H-NMR spectroscopy. Multivariate statistical analysis including principal components analysis (PCA) and partial least-squares discriminant analysis (PLS-DA) were performed. Metabolites identified were studied in relation to subsequent intervention procedures by receiver operating characteristic (ROC) curve analysis. Ten metabolites significantly different between CPE and non-CPE were identified. A significantly lower level of glucose for glycolysis was found in CPE compared to non-CPE. Six metabolites involving bacterial biosynthesis and three metabolites involving bacterial fermentation were significantly higher in CPE compared to non-CPE. Glucose and 3-hydroxybutyric acid were the metabolites found to be useful in discriminating from receiving intervention procedures. Metabolic profiling of pleural fluid using (1)H-NMR spectroscopy provides direct observation of bacterial metabolism in the progress of pneumococcal pneumonia. An increase in the metabolism of butyric acid fermentation of glucose could potentially lead to the need of aggressive pleural drainage.
Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, and Chang Gung University, Taoyuan, Taiwan.|Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, and Chang Gung University, Taoyuan, Taiwan.
Chih-Yung
CY
Chiu
Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, and Chang Gung University, Taoyuan, Taiwan.
Gigin
G
Lin
Graduate Institute of Medical Biotechnology, Chang Gung University, Taoyuan, Taiwan.
Mei-Ling
ML
Cheng
Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, and Chang Gung University, Taoyuan, Taiwan.
Meng-Han
MH
Chiang
Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, and Chang Gung University, Taoyuan, Taiwan.
Ming-Han
MH
Tsai
Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, and Chang Gung University, Taoyuan, Taiwan.
Shen-Hao
SH
Lai
Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, and Chang Gung University, Taoyuan, Taiwan.
Kin-Sun
KS
Wong
Department of Clinical Proteomics Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Sen-Yung
SY
Hsieh
D015415:Biomarkers / Q000032:analysis*; D002648:Child; D005122:Exudates and Transudates / Q000737:chemistry*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D055442:Metabolome; D010996:Pleural Effusion / Q000382:microbiology / Q000473:pathology*; D011018:Pneumonia, Pneumococcal / Q000150:complications*; D013296:Streptococcus pneumoniae / Q000378:metabolism*
D015415:Biomarkers