The feasibility of measuring bacterial load in exhaled breath of children with pneumonia and empyema using a novel point-of-care test: The BALLOON Study

Makuta, Gladys 2022. The feasibility of measuring bacterial load in exhaled breath of children with pneumonia and empyema using a novel point-of-care test: The BALLOON Study. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Pneumonia is the leading cause of deaths due to infectious diseases in children worldwide (1, 2). However, there is no gold standard procedure that can accurately, timely and non-invasively distinguish pneumonia from other selt-limiting respiratory tract infections that can safely be managed without antibiotics. This problem poses a risk of underprescribing of antibiotics that can lead to complicated pneumonia or over prescribing that is a contributing factor for growing resistance to antibiotics. The systematic review that included thirty-two papers confirmed that there are a few biomarkers that have shown potential for depicting pneumonia. These include Thiobarbituric acid reactive substances (TBARs), Leukotriene B4 (LTB4), Hydrogen peroxide, carbon monoxide and C-reactive protein (CRP), Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), a profile of Volatile organic compounds (VOCs), and Hepatocyte growth factor (HGF). However, these have not shown optimum accuracy and their effectiveness and efficacy has not been adequately investigated. Laboratory testing conducted in the initial stage of the project showed that it was possible to capture Lipopolysaccharide (LPS) using the method proposed in BALLOON Study. The experiments recovered an optimum percentage of endotoxin concentration with use of the shortest device, the large impact surface holder lip size (6 mm) and a nylon sampling surface. Overall, the 7 children, their mothers and 15 clinicians interviewed in the study, expressed that the device is user-friendly and not burdensome to children and service providers. However, clinicians indicated that the device would be particularly useful as a triage test and will need to prove to be adequately sensitive in order not to miss patients who could benefit from antibiotics. Analysis of breath samples from 10 children with pneumonia and 19 without respiratory infection showed that there was no significant difference in the concentration of the biomarkers investigated in the study (LPS, peptidoglycan [PG], cytokines, sTREM-1 and calprotectin) between cases and controls. Most of the biomarkers were below the level of detection. The results of BALLOON Study reveal that breath analysis has the potential for diagnosis of pneumonia as a point of care test. However, there is need for further research to establish the definitive biomarkers and optimum breath sample collection and analysis methods.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Medicine
Date of First Compliant Deposit:	8 August 2024
Last Modified:	08 Aug 2024 15:39
URI:	https://orca.cardiff.ac.uk/id/eprint/171262

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