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Infekcije urinarnog trakta jedna su od najčešćih bolesti uzrokovanih bakterijama. Najčešće se dijagnosticiraju analizom urina test-trakicom, mikroskopskim pregledom sedimenta urina nakon centrifugiranja i urinokulturom. ¹H-NMR-metabolomska analiza urina ima brojne prednosti pred navedenim metodama. U ovom radu dan je pregled predloženih dijagnostičkih algoritama koji se temelje na spektroskopiji nuklearne magnetske rezonancije (NMR). Sastav urina je izrazito varijabilan. Najpouzdaniji biomarkeri za dijagnostiku infekcija urinarnog trakta su trimetilamin i acetat te se mjerenjem njihovih koncentracija u nativnom urinu infekcije mogu dijagnosticirati s vrlo visokom osjetljivošću i specifičnošću. Neke vrste bakterija mogu se identificirati i kvantificirati snimanjem NMR-spektara urina nakon inkubacije uzoraka urina uz dodatak reagenasa za analizu. Snimanjem NMR-spektara nativnih uzoraka urina moguće je odrediti tip bakterije uzročnika infekcije. Najvažniji biomarkeri koji se koriste za razlikovanje infekcija uzrokovanih gram-negativnim bacilima od onih uzrokovanih gram- pozitivnim kokima su trimetilamin, sukcinat, acetat, laktat i etanol. Urinary tract infections are among the most common diseases caused by bacteria. They are most commonly diagnosed by urine swabs, microscopic examination of urine sediment after centrifugation, and bacteriological urine culture. ¹H NMR metabolomic analysis of urine has many advantages over listed methods. This thesis contains a review of proposed diagnostic algorithms based on nuclear magnetic resonance (NMR) spectroscopy. The composition of urine is highly variable. The most reliable biomarkers for diagnosis of urinary tract infections are trimethylamine and acetate. Infections can be diagnosed with very high sensitivity and specificity by measuring their concentrations in native urine samples. Some bacterial species can be identified and quantified by NMR spectroscopy of urine after the urine samples have been incubated with reagents for analysis. NMR spectroscopy of native urine samples allows identification of bacterial species responsible for infection. The most important biomarkers for distinguishing infections caused by gram-negative bacilli and those caused by gram-positive cocci are trimethylamine, succinate, acetate, lactate and ethanol. |
