呼吸机相关性肺炎病原菌释放VOCs的非靶向质谱分析

Analysis of VOCs Released of Pathogenic Bacteria of Ventilator Associated Pneumonia by Non-targeted Mass Spectrometry

  • 摘要: 呼吸机相关性肺炎(VAP)是一种主要由细菌引起的高发病率、高死亡率的感染性临床病症,通过检测呼气中的挥发性有机物(VOCs)来实现VAP的筛查与诊断,对相关呼气检测研究具有指导意义。本研究利用固相微萃取-气相色谱-质谱(SPME-GC-MS)技术在体外对铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌、阴沟肠杆菌、肺炎克雷伯菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌和表皮葡萄球菌等VAP病原菌主要菌种的顶空VOCs进行非靶向检测,发现8种细菌共释放了44种差异性VOCs,随后按酮、醛、醚、醇、酸、酯、烷烃、苯系物、酰胺和(含氮)杂环对这些菌源性VOCs进行分类讨论,较系统地报道了VAP病原菌释放VOCs种类的异同,为VAP相关的呼气检测研究提供了参考依据。

     

    Abstract: Ventilator associated pneumonia (VAP) is an infectious disease in clinic with high incidence rate (about 5%-40%) and mortality (about 10%), which is mainly caused by bacteria. At present, the clinical diagnosis of VAP depends on the microbial pathogen diagnosis of sputum samples from the lower respiratory tract. The whole process takes more than 24 hours, which is easy to cause antibiotic misuse and initial treatment failure. In recent years, breath test has received widespread attention due to its non-invasive and convenient characteristics, which attempt to screen and diagnose VAP through analysis of volatile organic compounds (VOCs) in exhalation. Therefore, the research on characterization of VOCs released by VAP pathogens has certain guiding significance for the related breath tests. In this study, the main VAP pathogenic bacteria, including P. aeruginosa, S. aureus, E. coli, E. cloacae, K. pneumoniae, A. baumannii, S. maltophilia, and S. epidermidis, were cultured in tryptic soy broth (TSB) culture medium in vitro, and their headspace samples were obtained after 10 hours of shaking culture. Then, non-targeted detection of VOCs in the headspace was performed by using solid phase microextraction coupled to gas chromatography-mass spectrometry (SPME-GC-MS). It was found that a total of 44 differential amounts of VOCs were released by the 8 strains. Subsequently, these bacterial VOCs were classified and discussed according to ketones, aldehydes, ethers, alcohols, acids, esters, alkanes, benzenes, amides, and (nitrogen-containing) heterocycles. These results showed that there was some consistency in the types of VOCs released by the 8 VAP pathogens, such as the production of dimethyl ether and methyl mercaptan. However, there were some differences in the released VOCs among the different pathogens. For example, only S. aureus released 2-butanone and 3-hydroxy-2-butanone, only E. coli produced acetic acid, only E. coli, S. maltophilia, and S. aureus produced N-nenenebc methylformamide. In addition, K. pneumoniae and P. aeruginosa released dimethyl disulfide (DMDS), and S. maltophilia released dimethyl trisulfide (DMTS). This study systematically reports the similarities and differences in the types of VOCs released by VAP pathogens, providing a reference and foundament for VAP related breath research. In the future, it is expected to achieve rapid and non-invasive screening of VAP through exhalation. However, this study did not detect clinically isolated strains or samples, and it was not possible to verify whether there were any differences in results between standard strains and clinical strains. In future work, it is necessary to consider the characteristic spectra of clinically isolated strains and the landmark VOCs in the exhalation of clinical patients.

     

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