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Updated: Jun 25, 2025
Capturing Actively Produced Microbial Volatile Organic Compounds from Human-Associated Samples with Vacuum-Assisted Sorbent Extraction
Published on: June 1, 2022
The Potential of Fecal Volatile Organic Compound Analysis for the Early Diagnosis of Late-Onset Sepsis in Preterm
Rimke R de Kroon1,2, Nina M Frerichs1,2, Eduard A Struys3
1Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Insights
Early detection of late-onset sepsis (LOS) in preterm infants is possible using fecal volatile organic compounds (VOCs). This non-invasive method shows promise for improving neonatal outcomes through early intervention.
Area of Science:
- Microbiology
- Neonatal Medicine
- Analytical Chemistry
Background:
- Late-onset sepsis (LOS) in preterm infants presents diagnostic challenges, with intestinal microbiota and metabolome changes preceding clinical symptoms.
- The preterm gut is a significant reservoir for bacterial pathogens contributing to LOS.
- Fecal volatile organic compounds (VOCs) offer insights into gut metabolic processes and host-microbiota interactions.
Purpose of the Study:
- To review advancements in developing a non-invasive, fecal VOC-based point-of-care test (POCT) for early detection of LOS.
- To explore the potential of VOC analysis for preclinical LOS diagnosis and targeted neonatal intervention.
- To highlight the challenges and future directions for a reliable LOS POCT.
Main Methods:
- Analysis of fecal volatile organic compounds (VOCs) as biomarkers for LOS.
- Review of existing studies on VOC profiles associated with LOS pathogens.
- Evaluation of various detection devices and their potential for point-of-care testing (POCT).
Main Results:
- Fecal VOC analysis can differentiate LOS patients from healthy individuals, particularly for Gram-negative pathogens.
- Overlapping VOC profiles among pathogens complicate species-specific identification.
- Disease-associated VOCs reflect complex gut metabolic and microbial interplay.
Conclusions:
- Non-invasive fecal VOC-based POCT holds significant potential for early LOS diagnosis in neonates.
- Addressing confounding variables and standardizing protocols are crucial for POCT development.
- Successful implementation could lead to timely interventions and improved neonatal clinical outcomes.
Abstract:
Early diagnosis and treatment of late-onset sepsis (LOS) is crucial for survival, but challenging. Intestinal microbiota and metabolome alterations precede the clinical onset of LOS, and the preterm gut is considered an important source of bacterial pathogens. Fecal volatile organic compounds (VOCs), formed by physiologic and pathophysiologic metabolic processes in the preterm gut, reflect a complex interplay between the human host, the environment, and microbiota. Disease-associated fecal VOCs can be detected with an array of devices with various potential for the development of a point-of-care test (POCT) for preclinical LOS detection. While characteristic VOCs for common LOS pathogens have been described, their VOC profiles often overlap with other pathogens due to similarities in metabolic pathways, hampering the construction of species-specific profiles. Clinical studies have, however, successfully discriminated LOS patients from healthy individuals using fecal VOC analysis with the highest predictive value for Gram-negative pathogens. This review discusses the current advancements in the development of a non-invasive fecal VOC-based POCT for early diagnosis of LOS, which may potentially provide opportunities for early intervention and targeted treatment and could improve clinical neonatal outcomes. Identification of confounding variables impacting VOC synthesis, selection of an optimal detection device, and development of standardized sampling protocols will allow for the development of a novel POCT in the near future.
