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Article: NMR-based metabolomic urinalysis: A rapid screening test for urinary tract infection

TitleNMR-based metabolomic urinalysis: A rapid screening test for urinary tract infection
Authors
Issue Date2014
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/cca
Citation
Clinica Chimica Acta, 2014, v. 436, p. 217–223 How to Cite?
AbstractBackground: Urinary tract infection (UTI) is one of the most common bacterial infections in humans; however, there is no accurate and fast quantitative test to detect UTI. Dipstick urinalysis is semi-quantitative with a limited diagnostic accuracy, while urine culture is accurate but takes time. We described a quantitative biochemical method for the diagnosis of bacteriuria using a single marker. Methods: We compared the urine metabolomes from 88 patients with bacterial UTI and 61 controls using 1H NMR spectroscopy followed by principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA). The biomarker identified was subsequently validated using independent samples. Results: The urine acetic acid/creatinine (mmol/mmol) level was determined to be the most discriminatory marker for bacterial UTI with an area-under-receiver operating characteristic curve. =. 0.97, sensitivity. =. 91% and specificity. =. 95% at the optimal cutoff 0.03. mmol/mmol. For validation, 60 samples were recruited prospectively. Using the optimal cutoff for acetic acid/creatinine, this method showed sensitivity. =. 96%, specificity. =. 94%, positive predictive value. =. 92%, negative predictive value. =. 97% and an overall accuracy. =. 95%. The diagnostic performance was superior to dipstick urinalysis or microscopy. In addition, we also observed an increase of urinary trimethylamine (TMA) in patients with Escherichia coli-associated UTI. TMA is a mammalian-microbial co-metabolite and the high level of TMA generated is related to the bacterial enzyme, trimethylamine N-oxide (TMAO) reductase which reduces TMAO to TMA. Conclusions: Urine acetic acid is a neglected metabolite that can be used for rapid diagnosis of UTI and TMA can be used for etiologic diagnosis of UTI. With the introduction of NMR-based clinical analyzers to clinical laboratories, NMR-based urinalysis can be translated for clinical use. © 2014 Elsevier B.V.
Persistent Identifierhttp://hdl.handle.net/10722/200725
ISSN
2015 Impact Factor: 2.799
2015 SCImago Journal Rankings: 1.040
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLam, CW-
dc.contributor.authorLaw, CY-
dc.contributor.authorTo, KKW-
dc.contributor.authorCheung, SKK-
dc.contributor.authorLee, KC-
dc.contributor.authorSze, KH-
dc.contributor.authorLeung, KF-
dc.contributor.authorYuen, KY-
dc.date.accessioned2014-08-21T06:58:00Z-
dc.date.available2014-08-21T06:58:00Z-
dc.date.issued2014-
dc.identifier.citationClinica Chimica Acta, 2014, v. 436, p. 217–223-
dc.identifier.issn0009-8981-
dc.identifier.urihttp://hdl.handle.net/10722/200725-
dc.description.abstractBackground: Urinary tract infection (UTI) is one of the most common bacterial infections in humans; however, there is no accurate and fast quantitative test to detect UTI. Dipstick urinalysis is semi-quantitative with a limited diagnostic accuracy, while urine culture is accurate but takes time. We described a quantitative biochemical method for the diagnosis of bacteriuria using a single marker. Methods: We compared the urine metabolomes from 88 patients with bacterial UTI and 61 controls using 1H NMR spectroscopy followed by principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA). The biomarker identified was subsequently validated using independent samples. Results: The urine acetic acid/creatinine (mmol/mmol) level was determined to be the most discriminatory marker for bacterial UTI with an area-under-receiver operating characteristic curve. =. 0.97, sensitivity. =. 91% and specificity. =. 95% at the optimal cutoff 0.03. mmol/mmol. For validation, 60 samples were recruited prospectively. Using the optimal cutoff for acetic acid/creatinine, this method showed sensitivity. =. 96%, specificity. =. 94%, positive predictive value. =. 92%, negative predictive value. =. 97% and an overall accuracy. =. 95%. The diagnostic performance was superior to dipstick urinalysis or microscopy. In addition, we also observed an increase of urinary trimethylamine (TMA) in patients with Escherichia coli-associated UTI. TMA is a mammalian-microbial co-metabolite and the high level of TMA generated is related to the bacterial enzyme, trimethylamine N-oxide (TMAO) reductase which reduces TMAO to TMA. Conclusions: Urine acetic acid is a neglected metabolite that can be used for rapid diagnosis of UTI and TMA can be used for etiologic diagnosis of UTI. With the introduction of NMR-based clinical analyzers to clinical laboratories, NMR-based urinalysis can be translated for clinical use. © 2014 Elsevier B.V.-
dc.languageeng-
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/cca-
dc.relation.ispartofClinica Chimica Acta-
dc.titleNMR-based metabolomic urinalysis: A rapid screening test for urinary tract infection-
dc.typeArticle-
dc.identifier.emailLam, CW: ching-wanlam@pathology.hku.hk-
dc.identifier.emailLaw, CY: ericlaw@pathology.hku.hk-
dc.identifier.emailTo, KKW: kelvinto@hkucc.hku.hk-
dc.identifier.emailCheung, SKK: skkc2011@hku.hk-
dc.identifier.emailLee, KC: lee1983@hku.hk-
dc.identifier.emailSze, KH: khsze@hku.hk-
dc.identifier.emailLeung, KF: orion45@hkusua.hku.hk-
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hk-
dc.identifier.authorityLam, CW=rp00260-
dc.identifier.authorityLaw, CY=rp01586-
dc.identifier.authorityTo, KKW=rp01384-
dc.identifier.authoritySze, KH=rp00785-
dc.identifier.authorityYuen, KY=rp00366-
dc.identifier.doi10.1016/j.cca.2014.05.014-
dc.identifier.pmid24909875-
dc.identifier.scopuseid_2-s2.0-84904677366-
dc.identifier.hkuros232316-
dc.identifier.volume436-
dc.identifier.spage217–223-
dc.identifier.epage217–223-
dc.identifier.isiWOS:000341463100035-
dc.publisher.placeNetherlands-

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