{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:06:26Z","timestamp":1787313986655,"version":"build-2736575974"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23AI121325"],"award-info":[{"award-number":["K23AI121325"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K01AI125413"],"award-info":[{"award-number":["K01AI125413"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001130","name":"Gerber Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000097","name":"NIH National Center for Research Resources","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000097","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Cincinnati Center for Clinical and Translational Science and Training","award":["5KL2TR000078"],"award-info":[{"award-number":["5KL2TR000078"]}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["R35GM136416"],"award-info":[{"award-number":["R35GM136416"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accurate diagnosis of community-acquired pneumonia (CAP) can be challenging. Clinical findings are nonspecific, and interpretations of chest radiographs have poor interrater reliability. Pilot studies demonstrate the potential for metabolomics to identify metabolite concentrations that differentiate children with CAP from those without. The objective of this study was to expand these findings in a large cohort of children with CAP compared with controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Urine was collected from children, 3 months to 12 years old, with emergency department visits for suspected CAP and community-based controls. Magnetic resonance spectrometry was used to identify and quantify metabolites. A random forest approach developed 3 models discriminating case patients from community-based controls based on (1) clinical signs and symptoms, (2) metabolites, and (3) the combination of both. The area under the receiver operating characteristic curve (AUC) was computed for each model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Included were 253 case patients and 122 controls. The metabolite-only model had similar discriminatory ability as the combination model (AUC, 0.97 and 0.99, respectively). The discriminating metabolites in the metabolite-only model were 2-aminobutyrate, fumarate, hypoxanthine, acetone, leucine, quinolinate, valine, O-acetylcarnitine, citrate, and trigonelline. In the combined model, discriminatory clinical factors included receipt of corticosteroids, fever, cough, rapid breathing, decreased oral intake, difficulty breathing, receipt of albuterol, abnormal sleepiness, vomiting, and wheezing and included 5 additional metabolites compared with the metabolite-only model (4-hydroxybenzoate, isoleucine, carnitine, 2-hydroxyisovalerate, betaine, and succinate).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Urine metabolite concentrations can accurately discriminate healthy children from children with suspected CAP. Metabolites associated with CAP may overcome limitations of prior diagnostic approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf072","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T15:21:59Z","timestamp":1739200919000},"page":"370-380","source":"Crossref","is-referenced-by-count":3,"title":["Urine Metabolites of Suspected Community-Acquired Pneumonia"],"prefix":"10.1093","volume":"232","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6242-607X","authenticated-orcid":false,"given":"Lilliam","family":"Ambroggio","sequence":"first","affiliation":[{"name":"Sections of Emergency Medicine and Hospital Medicine, Children\u2019s Hospital Colorado , Aurora, Colorado ,","place":["USA"]},{"name":"Department of Pediatrics, School of Medicine, University of Colorado , Aurora, Colorado ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4387-2605","authenticated-orcid":false,"given":"Todd A","family":"Florin","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Ann and Robert H. 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University of Michigan , Ann Arbor, Michigan ,","place":["USA"]},{"name":"Division of Pulmonary and Critical Care Medicine, University of Michigan , Ann Arbor, Michigan ,","place":["USA"]},{"name":"Weil Institute for Critical Care Research and Innovation, School of Medicine, University of Michigan , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3933-1574","authenticated-orcid":false,"given":"Heidi","family":"Sucharew","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center & Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Macaluso","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center & 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