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Open AccessArticle

Smell—Adding a New Dimension to Urinalysis

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Department of Pediatric Gastro-Enterology, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
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Department of Pediatrics, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
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Department of Pediatrics, OLVG Oost, 1091 AC Amsterdam, The Netherlands
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Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
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Department of Pediatric Nephrology, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Biosensors 2020, 10(5), 48; https://doi.org/10.3390/bios10050048
Received: 23 March 2020 / Revised: 30 April 2020 / Accepted: 3 May 2020 / Published: 5 May 2020
Background: Urinary tract infections (UTI) are among the most common infections in children. The primary tool to detect UTI is dipstick urinalysis; however, this has limited sensitivity and specificity. Therefore, urine culture has to be performed to confirm a UTI. Urinary volatile organic compounds (VOC) may serve as potential biomarker for diagnosing UTI. Previous studies on urinary VOCs focused on detection of UTI in a general population; therefore, this proof-of-principle study was set up in a clinical high-risk pediatric population. Methods: This study was performed at a tertiary nephro-urological clinic. Patients included were 0–18 years, clinically suspected of a UTI, and had abnormal urinalysis. Urine samples were divided into four groups, i.e., urine without bacterial growth, contamination, colonization, and UTI. VOC analysis was performed using an electronic nose (eNose) (Cyranose 320®) and VOC profiles of subgroups were compared. Results: Urinary VOC analysis discriminated between UTI and non-UTI samples (AUC 0.70; p = 0.048; sensitivity 0.67, specificity 0.70). The diagnostic accuracy of VOCs improved when comparing urine without bacterial growth versus with UTI (AUC 0.80; p = 0.009, sensitivity 0.79, specificity 0.75). Conclusions: In an intention-to-diagnose high-risk pediatric population, UTI could be discriminated from non-UTI by VOC profiling, using an eNose. Since eNose can be used as bed-side test, these results suggest that urinary VOC analysis may serve as an adjuvant in the diagnostic work-up of UTI in children. View Full-Text
Keywords: urinary tract infection; electronic nose; bacterial growth culture; volatile organic compounds urinary tract infection; electronic nose; bacterial growth culture; volatile organic compounds
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Visser, E.H.; Berkhout, D.J.C.; Singh, J.; Vermeulen, A.; Ashtiani, N.; de Boer, N.K.; van Wijk, J.A.E.; de Meij, T.G.; Bökenkamp, A. Smell—Adding a New Dimension to Urinalysis. Biosensors 2020, 10, 48.

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