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. 2023 Sep 20;9(10):e1533.
doi: 10.1097/TXD.0000000000001533. eCollection 2023 Oct.

Detection of Bacterial Colonization in Lung Transplant Recipients Using an Electronic Nose

Nynke Wijbenga  1   2 , Nadine L A de Jong  1   2   3 , Rogier A S Hoek  1   2 , Bas J Mathot  1   2 , Leonard Seghers  1   2 , Joachim G J V Aerts  1 , Daniel Bos  4   5 , Olivier C Manintveld  2   6 , Merel E Hellemons  1   2
Affiliations

Detection of Bacterial Colonization in Lung Transplant Recipients Using an Electronic Nose

Nynke Wijbenga et al. Transplant Direct. .

Abstract

Background: Bacterial colonization (BC) of the lower airways is common in lung transplant recipients (LTRs) and increases the risk of chronic lung allograft dysfunction. Diagnosis often requires bronchoscopy. Exhaled breath analysis using electronic nose (eNose) technology may noninvasively detect BC in LTRs. Therefore, we aimed to assess the diagnostic accuracy of an eNose to detect BC in LTRs.

Methods: We performed a cross-sectional analysis within a prospective, single-center cohort study assessing the diagnostic accuracy of detecting BC using eNose technology in LTRs. In the outpatient clinic, consecutive LTR eNose measurements were collected. We assessed and classified the eNose measurements for the presence of BC. Using supervised machine learning, the diagnostic accuracy of eNose for BC was assessed in a random training and validation set. Model performance was evaluated using receiver operating characteristic analysis.

Results: In total, 161 LTRs were included with 80 exclusions because of various reasons. Of the remaining 81 patients, 16 (20%) were classified as BC and 65 (80%) as non-BC. eNose-based classification of patients with and without BC provided an area under the curve of 0.82 in the training set and 0.97 in the validation set.

Conclusions: Exhaled breath analysis using eNose technology has the potential to noninvasively detect BC.

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Conflict of interest statement

J.G.J.V.A. reports personal fees and nonfinancial support from Merck Sharp & Dohme and personal fees from Bristol Myers Squibb's, Boehringer Ingelheim, Amphera, Eli Lilly, Takeda, Bayer, Roche, and Astra Zeneca outside the submitted work. In addition, J.G.J.V.A. has a patent on allogenic tumor cell lysate licensed to Amphera, a patent combination immunotherapy in cancer pending, and a patent biomarker for immunotherapy pending. O.M. reports personal fees from Astra Zeneca, Boehringer Ingelheim, and Novartis outside the submitted work. In addition, O.M. is Chair of the Working Group Heart Failure of the Dutch Society of Cardiology. The other authors declare no conflicts of interest.

Figures

None
Graphical abstract
FIGURE 1.
FIGURE 1.
Flowchart of assessed LTRs. BC, bacterial colonization; LTR, lung transplant recipients.
FIGURE 2.
FIGURE 2.
Discrimination between LTR with and without BC. A, Scatterplot of BC and non-BC samples plotted against the first 2 PLS components. Samples of the same class are connected to the class center identifier for improved visual assessment. B, ROC curves of train and test set. AUC, area under the curve; BC, bacterial colonization; LOOCV, leave-one-out cross-validation; non-BC, no bacterial colonization; PLS, partial least square; ROC, receiver operating characteristic.
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