Probert, C.S.; Jones, P.; Ratcliffe, N.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA93
Academic Journal
Clostridium difficile affects ca.15 000 people pa in England and Wales and results in 2100 bed days lost per DGH pa costs. Part of the problem is the delay in treatment—8.2 days in a recent series. Small round structured virus (SRSV/Norwalk) outbreaks result in ward closures. Early diagnosis will facilitate treatment or isolation. We have undertaking a study of the volatile compounds in stool of patients with diarrhoea (38) and healthy controls (6). Using a novel solid phase microextraction technique linked to gas chromatography and mass spectroscopy, we have characterised the key volatile compounds in normal stool and diarrhoea due to C difficile, SRSV, rotavirus, and Campylobacter jejuni. Diagnostically useful volatiles were: indole, 3-methylindole (3MI), 2-furancarbox-aldehyde (2FC), 5-methyl2-furancarboxaldehyde (5M2FC), ethyl dodecanoate (EDD), ammonia (Amm), the terpenes, and hydrocarbons (HC). The strength of association is shown using Χ² test, sensitivity and specificity, positive predictive value (PPV) and negative predictive values (NPV). Grouping some compounds increased their diagnostic value. These observations suggest that volatiles from stool samples could be used to rapidly diagnosis the cause of infectious diarrhoea. A device based on a portable MS machine could be used or an e-nose built. Our observation may lead to near patient testing on wards or in the field.


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