Emerging Biomarkers of Illness Severity: Urinary Metabolites Associated with Sepsis and Necrotizing Methicillin-Resistant Staphylococcus aureus Pneumonia.

摘要: tudy Objective To illustrate the potential of metabolomics to identify novel biomarkers illness severity in a child with fatal necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA). Design Case report two control groups and analysis. Patients An infant MRSA pneumonia, four children influenza (pneumonia group), seven healthy no known infections (healthy group). Measurements Main Results Urine samples were collected from all children. Metabolites identified quantified using 1H-nuclear magnetic resonance spectrometry. Normalized metabolite concentration data controls compared an unpaired Student's t test. To differentiating metabolites fold change each was calculated dividing urine patient median values same patients controls, respectively. Metscape (http://metscape.ncibi.org/), bioinformatics tool, used for visualization interpretation. Urine concentrations previously as associated sepsis (e.g., 3-hydroxybutyrate, carnitine, creatinine) higher those controls. The additional metabolites—acetone, acetoacetate, choline, fumarate, glucose 3-aminoisobutyrate—were more than 25-fold controls. Conclusion These metabolic changes preceded clinical severe phenotype, which suggests that detection extent disruption can aid early identification phenotype advance diagnosis. These also support utility development assays pediatric at high risk deterioration. This article is protected copyright. All rights reserved.