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- Publisher Website: 10.1016/j.cca.2014.07.038
- Scopus: eid_2-s2.0-84906346508
- PMID: 25108210
- WOS: WOS:000346616800005
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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
Title | Quantitative metabolomics of urine for rapid etiological diagnosis of urinary tract infection: Evaluation of a microbial-mammalian co-metabolite as a diagnostic biomarker |
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Authors | |
Keywords | Co-metabolites Escherichia coli NMR spectroscopy Quantitative metabolomics Trimethylamine Urinary tract infection |
Issue Date | 2015 |
Publisher | Elsevier 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? |
Abstract | Background: 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 Identifier | http://hdl.handle.net/10722/203187 |
ISSN | 2021 Impact Factor: 6.314 2020 SCImago Journal Rankings: 0.924 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lam, CW | - |
dc.contributor.author | Law, CY | - |
dc.contributor.author | Sze, KH | - |
dc.contributor.author | To, KKW | - |
dc.date.accessioned | 2014-09-19T12:56:52Z | - |
dc.date.available | 2014-09-19T12:56:52Z | - |
dc.date.issued | 2015 | - |
dc.identifier.citation | Clinica Chimica Acta, 2015, v. 438, p. 24-28 | - |
dc.identifier.issn | 0009-8981 | - |
dc.identifier.uri | http://hdl.handle.net/10722/203187 | - |
dc.description.abstract | Background: 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.language | eng | - |
dc.publisher | Elsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/cca | - |
dc.relation.ispartof | Clinica Chimica Acta | - |
dc.rights | Posting 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.subject | Co-metabolites | - |
dc.subject | Escherichia coli | - |
dc.subject | NMR spectroscopy | - |
dc.subject | Quantitative metabolomics | - |
dc.subject | Trimethylamine | - |
dc.subject | Urinary tract infection | - |
dc.title | Quantitative metabolomics of urine for rapid etiological diagnosis of urinary tract infection: Evaluation of a microbial-mammalian co-metabolite as a diagnostic biomarker | - |
dc.type | Article | - |
dc.identifier.email | Lam, CW: ching-wanlam@pathology.hku.hk | - |
dc.identifier.email | Law, CY: ericlaw@pathology.hku.hk | - |
dc.identifier.email | Sze, KH: khsze@hku.hk | - |
dc.identifier.email | To, KKW: kelvinto@hkucc.hku.hk | - |
dc.identifier.authority | Lam, CW=rp00260 | - |
dc.identifier.authority | Law, CY=rp01586 | - |
dc.identifier.authority | Sze, KH=rp00785 | - |
dc.identifier.authority | To, KKW=rp01384 | - |
dc.identifier.doi | 10.1016/j.cca.2014.07.038 | - |
dc.identifier.pmid | 25108210 | - |
dc.identifier.scopus | eid_2-s2.0-84906346508 | - |
dc.identifier.hkuros | 239329 | - |
dc.identifier.volume | 438 | - |
dc.identifier.spage | 24 | - |
dc.identifier.epage | 28 | - |
dc.identifier.isi | WOS:000346616800005 | - |
dc.publisher.place | Netherlands | - |
dc.identifier.issnl | 0009-8981 | - |