Abstract：
Clostridioides difficileinfection (CDI) is the leading cause of hospital-acquired infective diarrhea. Current methods for diagnosing CDI have limitations; enzyme immunoassays for toxin have low sensitivity andClostridioides difficilepolymerase chain reaction cannot differentiate infection from colonization. An ideal diagnostic test that incorporates microbial factors, host factors, and host-microbe interaction might characterize true infection. Assessing volatile organic compounds (VOCs) in exhaled breath may be a useful test for identifying CDI. To identify a wide selection of VOCs in exhaled breath, we used thermal desorption-gas chromatography-mass spectrometry to study breath samples from 17 patients with CDI. Age- and sex-matched patients with diarrhea and negativeC.difficiletesting (no CDI) were used as controls. Of the 65 VOCs tested, 9 were used to build a quadratic discriminant model that showed a final cross-validated accuracy of 74%, a sensitivity of 71%, a specificity of 76%, and a receiver operating characteristic area under the curve of 0.72. If these findings are proven by larger studies, breath VOC analysis may be a helpful adjunctive diagnostic test for CDI.
摘要：
艰难梭菌感染（CDI）是医院获得性感染性腹泻的主要原因。目前诊断CDI的方法有局限性；毒素的酶免疫测定灵敏度低，艰难梭菌聚合酶链反应不能区分感染和定植。结合微生物因素的理想诊断测试，宿主因素,宿主-微生物相互作用可能是真正感染的特征。评估呼出气中的挥发性有机化合物（VOC）可能是识别CDI的有用测试。为了识别呼出气中的多种挥发性有机化合物，我们使用热解吸-气相色谱-质谱法研究了17例CDI患者的呼吸样本。年龄和性别匹配的腹泻和阴性患者。使用艰难试验(无CDI)作为对照。在测试的65种挥发性有机化合物中，9用于构建二次判别模型，该模型显示最终交叉验证的准确率为74%，灵敏度为71%,特异性为76%，曲线下的接收器工作特征面积为0.72。如果这些发现被更大的研究证明，呼气VOC分析可能是CDI的辅助诊断试验.
