Volatile organic compound detection as a potential means of diagnosing cutaneous wound infections

Abstract

Chronic cutaneous wound infections and surgical site infections (SSIs) present a huge burden on the healthcare system and can lead to increased morbidity and mortality. Current diagnostic methods of identifying and confirming infection involve culture-based and molecular methods. Both techniques are time-consuming and delays commonly lead to untargeted empirical treatment. An ideal diagnostic method would be noninvasive and highly sensitive and detect pathogenic organisms with a high degree of accuracy to allow targeted treatment. Volatile organic compounds (VOCs) are a diverse group of carbon-based molecules produced and released by humans and microorganisms. VOC detection has the potential in aiding cutaneous wound infection diagnostics using noninvasive and time-efficient methods. This review provides a comprehensive update on VOCs produced and emitted by bacteria commonly associated with chronic wounds and SSIs. VOC sampling has the advantage of being painless, time-efficient, noninvasive, and reproducible. VOCs emitted by these organisms are diverse. In vitro studies have identified potential signature volatile profiles, which can be used in detecting these microorganisms. Combining these profiles with volatile profiles emitted from acute, chronic and surgical wounds in vivo could potentially allow identification of bacterial-specific VOCs. VOC detection has the potential for a relatively inexpensive, portable, noninvasive, and reliable clinical diagnostic tool, which could be used in detecting cutaneous wound infections and guiding their optimal management.

Electrical stimulation disrupts biofilms in a human wound model and reveals the potential for monitoring treatment response with volatile biomarkers

“…Current monitoring of wound infection response to treatment involves a combination of clinical indicators which are subjective and microbial sampling for laboratory culturing and sequencing, which are limited by time and accuracy . The use of VOCs and its application in point of care testing, such as electronic nose technologies in wound infection diagnoses, have been investigated and discussed previously . As with the use of VOC profiles in the diagnosis of lung disease, their use as potential markers in monitoring treatment response have been more robustly investigated, compared to their use in monitoring wound infection response to treatment, which is limited .…”

Volatile Organic Compound and Metabolite Signatures as Pathogen Identifiers and Biomarkers of Infectious Disease

“…Here we summarize the various methods used for VOC detection. The advantages and limitations associated with these techniques and instruments are summarized in Table 1, and reviewed in detail elsewhere (see [17,21,27,28]). …”

“…Samples for GC-MS must be in the gaseous phase such that a pure inert carrier gas can transport the sample through the chromatographic column. Depending on the VOC concentration, sample pre-concentration may be required [21]. Compound resolution improves as the length of the chromatographic column increases.…”

“…However, care must be taken to avoid contaminating the sample with cosmetics, perfumes, or compounds present in the ambient air. This may be especially difficult given that even trace VOCs associated with the preservatives found in skin creams and gels are detectable in skin swab samples [21].…”

Use of voltammetric analysis for fast and objective discrimination of the etiology, evolution, and bacterial infection of lower limb ulcers

“…Innovative techniques based on the analysis of volatile organic compounds (VOCs) or on voltammetric analysis (VA) have been shown in preliminary studies to be able to diagnose infection or to discriminate ulcer severity …”