Metabolomics strategy for diagnosing urinary tract infections

Area of Science:

• Biochemistry
• Clinical Diagnostics
• Microbiology

Background:

• Metabolomics is a powerful tool for studying metabolic phenotypes but is not yet standard in clinical diagnostics.
• Urinary tract infections (UTIs) present an opportunity for metabolomics due to concentrated microbial byproducts in urine.
• Identifying specific urinary biomarkers could enable faster UTI diagnosis.

Purpose of the Study:

• To investigate the potential of metabolomics for diagnosing UTIs.
• To identify specific metabolites that can serve as accurate biomarkers for UTIs.
• To develop a rapid diagnostic assay for UTI detection.

Main Methods:

• Conducted an untargeted metabolomics screen of clinical urine samples from patients with suspected UTIs.
• Identified agmatine and N6-methyladenine as predictive metabolites for culture-positive UTIs.
• Developed and validated a rapid liquid chromatography-mass spectrometry (LC-MS) assay for quantifying these metabolites.

Main Results:

• Agmatine and N6-methyladenine were identified as predictive biomarkers for UTIs.
• The developed LC-MS assay accurately identified UTIs caused by a wide range of bacterial species (over 90% of infections).
• The identified metabolites demonstrated robust predictive performance across two large, blinded patient cohorts (1629 samples).

Conclusions:

• Metabolomics, using agmatine and N6-methyladenine, shows significant potential for the rapid clinical diagnosis of UTIs.
• This approach offers a faster alternative to traditional urine culture methods for UTI detection.
• The findings support the integration of metabolomics into routine clinical diagnostics for infectious diseases.