Smell - Adding a New Dimension to Urinalysis.

Area of Science:

• Pediatric Nephrology
• Infectious Diseases
• Biomarker Discovery

Background:

• Urinary tract infections (UTIs) are common in children, but current diagnostic methods like dipstick urinalysis lack sensitivity and specificity.
• Urine culture is the gold standard but is time-consuming.
• Urinary volatile organic compounds (VOCs) are emerging as potential non-invasive biomarkers for UTI diagnosis.

Purpose of the Study:

• To investigate the potential of urinary VOCs as biomarkers for UTI diagnosis in a high-risk pediatric population.
• To evaluate the efficacy of an electronic nose (eNose) for detecting UTI-associated VOC profiles.

Main Methods:

• A proof-of-principle study was conducted at a tertiary nephro-urological clinic.
• Urine samples from pediatric patients (0-18 years) with suspected UTI and abnormal urinalysis were analyzed.
• VOC analysis was performed using an electronic nose (eNose), comparing samples with and without bacterial growth, contamination, or UTI.

Main Results:

• Urinary VOC analysis using eNose successfully discriminated between UTI and non-UTI samples (AUC 0.70, p=0.048).
• Diagnostic accuracy improved when comparing UTI with samples lacking bacterial growth (AUC 0.80, p=0.009).
• Sensitivity and specificity for UTI vs. non-UTI were 0.67 and 0.70, respectively, improving to 0.79 and 0.75 when comparing UTI vs. no bacterial growth.

Conclusions:

• VOC profiling with an eNose can discriminate UTI from non-UTI in high-risk pediatric patients.
• The eNose's potential as a bedside test suggests urinary VOC analysis could be a valuable adjunct diagnostic tool for pediatric UTIs.
• This study highlights the promise of VOCs as rapid, non-invasive biomarkers in pediatric infectious disease diagnostics.