Utility, feasibility, and socio-demographic considerations in the diagnosis of bacterial RTI's by GC-IMS breath analysis

Trenton K Stewart; Emma Brodrick; Matthew J Reed; Andrea M Collins; Emma Daulton; Emily Adams; Nicholas Feasey; Libbe Ratcliffe; Diane Exley; Stacy Todd; Nadja van Ginneken; Amandip Sahota; Graham Devereux; E M Williams; James A Covington

doi:10.1016/j.isci.2024.110610

Utility, feasibility, and socio-demographic considerations in the diagnosis of bacterial RTI's by GC-IMS breath analysis

iScience. 2024 Jul 30;27(9):110610. doi: 10.1016/j.isci.2024.110610. eCollection 2024 Sep 20.

Authors

Trenton K Stewart^{1

2}, Emma Brodrick³, Matthew J Reed^{4

5}, Andrea M Collins^{6

7

8}, Emma Daulton², Emily Adams⁶, Nicholas Feasey⁶, Libbe Ratcliffe⁷, Diane Exley⁹, Stacy Todd⁷, Nadja van Ginneken^{9

10}, Amandip Sahota¹¹, Graham Devereux^{6

7}, E M Williams¹², James A Covington²

Affiliations

¹ Warwick Medical School, University of Warwick, Coventry, UK.
² School of Engineering, University of Warwick, Coventry, UK.
³ IMSPEX Diagnostics Ltd., Wales, UK.
⁴ Emergency Medicine Research Group Edinburgh (EMERGE), Royal Infirmary of Edinburgh, Edinburgh, UK.
⁵ Acute Care Edinburgh, Usher Institute, University of Edinburgh, Edinburgh, UK.
⁶ Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
⁷ Liverpool University Hospitals NHS Trust, Liverpool, UK.
⁸ NIHR CRN Northwest Coast, Liverpool, UK.
⁹ Brownlow Health, Liverpool, UK.
¹⁰ Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK.
¹¹ Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK.
¹² University of South Wales, Newport, UK.

Abstract

Diagnosis of respiratory tract infections (RTIs), especially in primary care, is typically made on clinical features and in the absence of quick and reliable diagnostic tests. Even in secondary care, where diagnostic microbiology facilities are available, these tests take 24-48 h to provide an indication of the etiology. This multicentre study used a portable gas chromatography-ion mobility spectrometer (GC-IMS) for the diagnosis of bacterial RTIs. Breath samples taken from 570 participants with 149 clinically validated bacterial and 421 non-bacterial RTIs were analyzed to distinguish bacterial from non-bacterial RTIs. Through the integration of a sparse logistic regression model, we identified a moderate diagnostic accuracy of 0.73 (95% CI 0 · 69, 0 · 77) alongside a sensitivity of 0 · 85 (95% CI 0 · 79, 0 · 91) and a specificity of 0 · 55 (95% CI 0 · 50, 0 · 60). The GC-IMS diagnostic device provides a promising outlook in distinguishing bacterial from non-bacterial RTIs and was also favorably viewed by participants.

Keywords: Analytical chemistry; Chemistry; Diagnostics.