Diagnosing viral and bacterial respiratory infections in acute COPD exacerbations by an electronic nose: a pilot study.
Respiratory infections, viral or bacterial, are a common cause of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). A rapid, point-of-care, and easy-to-use tool distinguishing viral and bacterial from other causes would be valuable in routine clinical care. An electronic nose (e-nose) could fit this profile but has never been tested in this setting before. In a single-center registered trial (NTR 4601) patients admitted with AECOPD were tested with the Aeonose(®) electronic nose, and a diagnosis of viral or bacterial infection was obtained by bacterial culture on sputa and viral PCR on nose swabs. A neural network with leave-10%-out cross-validation was used to assess the e-nose data. Forty three patients were included. In the bacterial infection model, 22 positive cases were tested versus the negatives; and similarly 18 positive cases were tested in the viral infection model. The Aeonose was able to distinguish between COPD-subjects suffering from a viral infection and COPD patients without infection, showing an area under the curve (AUC) of 0.74. Similarly, for bacterial infections, an AUC of 0.72 was obtained. The Aeonose e-nose yields promising results in 'smelling' the presence or absence of a viral or bacterial respiratory infection during an acute exacerbation of COPD. Validation of these results using a new and large cohort is required before introduction into clinical practice.
University of Groningen, Department of Pulmonary Diseases, University Medical Center Groningen, The Netherlands.
Wouter H
WH
van Geffen
Marcel
M
Bruins
Huib A M
HA
Kerstjens
D000208:Acute Disease; D000368:Aged; D001424:Bacterial Infections / Q000175:diagnosis*; D001944:Breath Tests; D018450:Disease Progression; D062609:Electronic Nose; D045853:Exhalation; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000382:microbiology* / Q000821:virology; D012372:ROC Curve; D012141:Respiratory Tract Infections / Q000382:microbiology* / Q000821:virology*; D014777:Virus Diseases / Q000175:diagnosis*