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Article: Quantitative metabolomics of urine for rapid etiological diagnosis of urinary tract infection: Evaluation of a microbial-mammalian co-metabolite as a diagnostic biomarker

TitleQuantitative metabolomics of urine for rapid etiological diagnosis of urinary tract infection: Evaluation of a microbial-mammalian co-metabolite as a diagnostic biomarker
Authors
Issue Date2015
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/cca
Citation
Clinica Chimica Acta, 2015, v. 438, p. 24-28 How to Cite?
AbstractBackground: We have previously reported a NMR-based urinalysis for the screening of urinary tract infection (UTI) with high accuracy and reproducibility. Urinary acetic acid per creatinine was found to be a diagnostic marker of bacterial UTI with an area-under-receiver operating characteristic (ROC) curve of 0.97. In addition, we identified trimethylamine (TMA) as a human-microbial marker of Escherichia coli (EC)-associated UTI. Here, we evaluate the clinical application of NMR-based urinalysis in aiding the etiological diagnosis of bacterial UTI. Methods: Proton NMR spectroscopy was acquired using a Bruker 600. MHz spectroscopy for 88 urine samples from patients with bacterial UTI, confirmed by urine culture. The spectra were analyzed using orthogonal partial least squares-discriminant analysis (OPLS-DA). ROC curve analysis was performed after the quantitation of the urine metabolites. Results: The TMA/creatinine (mmol/mmol) level was determined to be a specific marker for EC-associated UTI. It has an area-under-ROC. = 0.85 (95% confidence interval: 0.75-0.91). For the etiological diagnosis, the cutoff for 97.0% specificity was at 0.0117. mmol/mmol creatinine for EC-associated UTI with a sensitivity of 66.7%. The mean of TMA/creatinine of EC is 21-fold that of non-EC. Conclusions: The co-metabolism of TMA by EC and human cells makes TMA an ideal urine biomarker for UTI. The presence of TMA in a freshly collected sample eliminates the possibility of contamination of urine by bacteria during the collection process resulting in a positive bacterial culture result. We envisage the NMR-based urinalysis of urinary TMA that can be a useful method for the etiological diagnosis of EC-associated UTI. © 2014 Elsevier B.V.
Persistent Identifierhttp://hdl.handle.net/10722/203187
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.authorSze, KH-
dc.contributor.authorTo, KKW-
dc.date.accessioned2014-09-19T12:56:52Z-
dc.date.available2014-09-19T12:56:52Z-
dc.date.issued2015-
dc.identifier.citationClinica Chimica Acta, 2015, v. 438, p. 24-28-
dc.identifier.issn0009-8981-
dc.identifier.urihttp://hdl.handle.net/10722/203187-
dc.description.abstractBackground: We have previously reported a NMR-based urinalysis for the screening of urinary tract infection (UTI) with high accuracy and reproducibility. Urinary acetic acid per creatinine was found to be a diagnostic marker of bacterial UTI with an area-under-receiver operating characteristic (ROC) curve of 0.97. In addition, we identified trimethylamine (TMA) as a human-microbial marker of Escherichia coli (EC)-associated UTI. Here, we evaluate the clinical application of NMR-based urinalysis in aiding the etiological diagnosis of bacterial UTI. Methods: Proton NMR spectroscopy was acquired using a Bruker 600. MHz spectroscopy for 88 urine samples from patients with bacterial UTI, confirmed by urine culture. The spectra were analyzed using orthogonal partial least squares-discriminant analysis (OPLS-DA). ROC curve analysis was performed after the quantitation of the urine metabolites. Results: The TMA/creatinine (mmol/mmol) level was determined to be a specific marker for EC-associated UTI. It has an area-under-ROC. = 0.85 (95% confidence interval: 0.75-0.91). For the etiological diagnosis, the cutoff for 97.0% specificity was at 0.0117. mmol/mmol creatinine for EC-associated UTI with a sensitivity of 66.7%. The mean of TMA/creatinine of EC is 21-fold that of non-EC. Conclusions: The co-metabolism of TMA by EC and human cells makes TMA an ideal urine biomarker for UTI. The presence of TMA in a freshly collected sample eliminates the possibility of contamination of urine by bacteria during the collection process resulting in a positive bacterial culture result. We envisage the NMR-based urinalysis of urinary TMA that can be a useful method for the etiological diagnosis of EC-associated UTI. © 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.rightsPosting accepted manuscript (postprint): © <year>. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/-
dc.titleQuantitative metabolomics of urine for rapid etiological diagnosis of urinary tract infection: Evaluation of a microbial-mammalian co-metabolite as a diagnostic biomarker-
dc.typeArticle-
dc.identifier.emailLam, CW: ching-wanlam@pathology.hku.hk-
dc.identifier.emailLaw, CY: ericlaw@pathology.hku.hk-
dc.identifier.emailSze, KH: khsze@hku.hk-
dc.identifier.emailTo, KKW: kelvinto@hkucc.hku.hk-
dc.identifier.authorityLam, CW=rp00260-
dc.identifier.authorityLaw, CY=rp01586-
dc.identifier.authoritySze, KH=rp00785-
dc.identifier.authorityTo, KKW=rp01384-
dc.identifier.doi10.1016/j.cca.2014.07.038-
dc.identifier.pmid25108210-
dc.identifier.scopuseid_2-s2.0-84906346508-
dc.identifier.hkuros239329-
dc.identifier.volume438-
dc.identifier.spage24-
dc.identifier.epage28-
dc.identifier.isiWOS:000346616800005-
dc.publisher.placeNetherlands-

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