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Volume 6 Journal of Infectious Diseases and Therapy
ISSN: 2332-0877 Infection Congress 2018
March 01-02, 2018
March 01-02, 2018 Berlin, Germany
5th International Congress on
INFECTIOUS DISEASES
Proof-of-concept study to determine the feasibility of measuring bacterial load in exhaled breath of
children with pneumonia and empyema using a novel point-of-care test
Gladys Makuta, Colin Powell, Bastiaan Hoogendoorn, Clive Gregory, Jenna Bowen and Rhiannon Phillips
Cardiff University, UK
Background: Pneumonia is a leading cause of death in children. Approximately 75% of patients with acute respiratory tract
infections (ARTI) receive antibiotics despite most of these infections having viral origin. Early diagnosis and appropriate
treatment is essential. There is no point-of-care (POC) test, available to diagnose bacterial pneumonia. This study aims to
investigate the feasibility of developing a POC device that will measure bacterial load in breath from children with pneumonia
and empyema. The purpose is to find a diagnostic POC test capable of isolating bacterial pneumonia.
Methods: This study is designed to show that a POC breath test can detect the difference in bacterial load (through assay of
lipopolysaccharide (LPS) and peptidoglycan) in exhaled breath of children with pneumonia/empyema and those without a
chest infection (controls). It comprises of development of a breath sampler, laboratory and clinical testing. Three prototypes
of the breath sampler were produced in phases with refinement. Each prototype underwent laboratory testing using a known
concentration of endotoxin which was nebulized thorough the prototype incorporating a sampling surface (SS). Subsequently,
a sample of endotoxin impinged on the SS was extracted and tested using limulus amebocyte lysate (LAL) assay. Clinical
testing involves collecting breath samples from 48 children between 5 to 15 years with pneumonia/empyema and well matched
controls. Semi-structured qualitative interviews will be conducted with participants, parents and clinicians to examine the
acceptability of the test.
Results: A breath sampler, suitable for clinical testing has been developed. Results from laboratory testing show that it is
possible to detect nebulized endotoxins (comparable to levels detectable in breath) using the LAL assay.
Discussion & Conclusion: The study will demonstrate the potential of using a POC test to identify children with pneumonia
or empyema who may benefit from antibiotics.
References
1. Shah S N, et al., (2017) Does This Child Have Pneumonia?: the rational clinical examination systematic review. Jama
318(5):462-471.
2. Schuetz P, et al., (2009) Effect of procalcitonin-based guidelines vs. standard guidelines on antibiotic use in lower
respiratory tract infections: the ProHOSP randomized controlled trial. Jama 302(10):1059-1066.
3. Wootton D and C Feldman (2014) The diagnosis of pneumonia requires a chest radiograph (X-ray)–yes, no or
sometimes? Pneumonia 5(1):1.
4. Bartlett J G (2011) Diagnostic tests for agents of community-acquired pneumonia. Clinical Infectious Diseases
52(4):S296-S30.
Biography
Gladys Makuta completed her MSc in International Health and Management and BA in Health Sciences and Social Services. She is currently a PhD student in
the Division of Population Medicine at Cardiff University, United Kingdom, working on the balloon study. She has strong research interest in infection detection,
prevention and management in a global health context. She has significant experience in commercial and non-commercial clinical research and teaching gained
from both developed and resource limited areas, prior to her current role.
Gladys Makuta et al., J Infect Dis Ther 2018, Volume 6
DOI: 10.4172/2332-0877-C1-039