Untargeted molecular analysis of exhaled breath as a diagnostic test for ventilator-associated lower respiratory tract infections (BreathDx)

van Oort, Pouline MP and Nijsen, Tamara M and White, Iain R and Knobel, Hugo H and Felton, Timothy and Rattray, Nicholas and Lawal, Oluwasola and Bulut, Mustaza and Ahmed, Waqar and Artigas, Antonio and Povoa, Pedro R and Martin-Loeches, Ignacio and Weda, Hans and Goodacre, Royston and Schultz, Marcus J and Dark, Paul M and Fowler, Stephen J and Bos, Lieuwe D (2021) Untargeted molecular analysis of exhaled breath as a diagnostic test for ventilator-associated lower respiratory tract infections (BreathDx). Thorax. 217362. ISSN 0040-6376 (https://doi.org/10.1136/thoraxjnl-2021-217362)

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Abstract

Patients suspected of ventilator-associated lower respiratory tract infections (VA-LRTIs) commonly receive broad-spectrum antimicrobial therapy unnecessarily. We tested whether exhaled breath analysis can discriminate between patients suspected of VA-LRTI with confirmed infection, from patients with negative cultures. Breath from 108 patients suspected of VA-LRTI was analysed by gas chromatography-mass spectrometry. The breath test had a sensitivity of 98% at a specificity of 49%, confirmed with a second analytical method. The breath test had a negative predictive value of 96% and excluded pneumonia in half of the patients with negative cultures. Trial registration number: UKCRN ID number 19086, registered May 2015

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