Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis

Hydrogen cyanide is readily detected in the headspace above Pseudomonas aeruginosa cultures and in the breath of cystic fibrosis (CF) patients with chronic (P. aeruginosa) infection. We investigated if exhaled breath HCN is an early marker of P. aeruginosa infection. 233 children with CF who were...

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Main Authors: Gilchrist, Francis J., Belcher, John, Jones, Andrew M., Smith, David, Smyth, Alan R., Southern, Kevin W., Španěl, Patrik, Webb, A. Kevin, Lenney, Warren
Format: Article
Published: European Respiratory Society 2015
Online Access:https://eprints.nottingham.ac.uk/31677/
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author Gilchrist, Francis J.
Belcher, John
Jones, Andrew M.
Smith, David
Smyth, Alan R.
Southern, Kevin W.
Španěl, Patrik
Webb, A. Kevin
Lenney, Warren
author_facet Gilchrist, Francis J.
Belcher, John
Jones, Andrew M.
Smith, David
Smyth, Alan R.
Southern, Kevin W.
Španěl, Patrik
Webb, A. Kevin
Lenney, Warren
author_sort Gilchrist, Francis J.
building Nottingham Research Data Repository
collection Online Access
description Hydrogen cyanide is readily detected in the headspace above Pseudomonas aeruginosa cultures and in the breath of cystic fibrosis (CF) patients with chronic (P. aeruginosa) infection. We investigated if exhaled breath HCN is an early marker of P. aeruginosa infection. 233 children with CF who were free from P. aeruginosa infection were followed for 2 years. Their median (interquartile range) age was 8.0 (5.0–12.2) years. At each study visit, an exhaled breath sample was collected for hydrogen cyanide analysis. In total, 2055 breath samples were analysed. At the end of the study, the hydrogen cyanide concentrations were compared to the results of routine microbiology surveillance. P. aeruginosa was isolated from 71 children during the study with an incidence (95% CI) of 0.19 (0.15–0.23) cases per patient-year. Using a random-effects logistic model, the estimated odds ratio (95% CI) was 3.1 (2.6–3.6), which showed that for a 1- ppbv increase in exhaled breath hydrogen cyanide, we expected a 212% increase in the odds of P. aeruginosa infection. The sensitivity and specificity were estimated at 33% and 99%, respectively. Exhaled breath hydrogen cyanide is a specific biomarker of new P. aeruginosa infection in children with CF. Its low sensitivity means that at present, hydrogen cyanide cannot be used as a screening test for this infection.
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spelling nottingham-316772020-05-04T17:22:58Z https://eprints.nottingham.ac.uk/31677/ Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis Gilchrist, Francis J. Belcher, John Jones, Andrew M. Smith, David Smyth, Alan R. Southern, Kevin W. Španěl, Patrik Webb, A. Kevin Lenney, Warren Hydrogen cyanide is readily detected in the headspace above Pseudomonas aeruginosa cultures and in the breath of cystic fibrosis (CF) patients with chronic (P. aeruginosa) infection. We investigated if exhaled breath HCN is an early marker of P. aeruginosa infection. 233 children with CF who were free from P. aeruginosa infection were followed for 2 years. Their median (interquartile range) age was 8.0 (5.0–12.2) years. At each study visit, an exhaled breath sample was collected for hydrogen cyanide analysis. In total, 2055 breath samples were analysed. At the end of the study, the hydrogen cyanide concentrations were compared to the results of routine microbiology surveillance. P. aeruginosa was isolated from 71 children during the study with an incidence (95% CI) of 0.19 (0.15–0.23) cases per patient-year. Using a random-effects logistic model, the estimated odds ratio (95% CI) was 3.1 (2.6–3.6), which showed that for a 1- ppbv increase in exhaled breath hydrogen cyanide, we expected a 212% increase in the odds of P. aeruginosa infection. The sensitivity and specificity were estimated at 33% and 99%, respectively. Exhaled breath hydrogen cyanide is a specific biomarker of new P. aeruginosa infection in children with CF. Its low sensitivity means that at present, hydrogen cyanide cannot be used as a screening test for this infection. European Respiratory Society 2015-11-16 Article PeerReviewed Gilchrist, Francis J., Belcher, John, Jones, Andrew M., Smith, David, Smyth, Alan R., Southern, Kevin W., Španěl, Patrik, Webb, A. Kevin and Lenney, Warren (2015) Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis. ERJ Open Research, 1 (2). ISSN 2312-0541 http://openres.ersjournals.com/content/1/2/00044-2015 doi:10.1183/23120541.00044-2015 doi:10.1183/23120541.00044-2015
spellingShingle Gilchrist, Francis J.
Belcher, John
Jones, Andrew M.
Smith, David
Smyth, Alan R.
Southern, Kevin W.
Španěl, Patrik
Webb, A. Kevin
Lenney, Warren
Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis
title Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis
title_full Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis
title_fullStr Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis
title_full_unstemmed Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis
title_short Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis
title_sort exhaled breath hydrogen cyanide as a marker of early pseudomonas aeruginosa infection in children with cystic fibrosis
url https://eprints.nottingham.ac.uk/31677/
https://eprints.nottingham.ac.uk/31677/
https://eprints.nottingham.ac.uk/31677/