{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T19:37:45Z","timestamp":1793129865657,"version":"4.5.0"},"reference-count":38,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100013297","name":"Eurostars","doi-asserted-by":"publisher","award":["BREATHCOUNTS 3718"],"award-info":[{"award-number":["BREATHCOUNTS 3718"]}],"id":[{"id":"10.13039\/100013297","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013348","name":"Innosuisse - Schweizerische Agentur f\u00fcr Innovationsf\u00f6rderung","doi-asserted-by":"publisher","award":["107.660 SIP-LS"],"award-info":[{"award-number":["107.660 SIP-LS"]}],"id":[{"id":"10.13039\/501100013348","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2026,10,14]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Etiological diagnosis of lower respiratory tract infections (LRTIs) relies on sputum or bronchoalveolar lavage (BAL), which may be difficult to obtain or invasive. Exhaled breath aerosol (XBA) sampling offers a noninvasive alternative for pathogen detection. We evaluated the performance of the AveloMask, a face mask-based device designed to capture XBAs for molecular testing. In this prospective paired-sample study, hospitalized adults with pneumonia at three hospitals in Switzerland and Georgia provided an XBA sample using the AveloMask and a lower respiratory tract (LRT) specimen (sputum or BAL). XBA samples were analyzed by multiplex PCR using the Roche LightMix\u00ae panel, and LRT samples were tested using the BioFire\u00ae FilmArray\u00ae Pneumonia Panel. Concordance between XBA and LRT samples was assessed using positive percent agreement (PPA), negative percent agreement (NPA), and overall percent agreement (OPA). A total of 93 participants were enrolled, and 63 participants provided paired samples. AveloMask sampling identified the dominant pathogen (lowest Ct value in the LRT sample) in 40\/47 LRT-positive cases (85.1%). Across all targets, PPA was 61% (95% CI, 50%\u201372%), NPA was 99.8% (95% CI, 99%\u2013100%), and OPA was 95% (95% CI, 92%\u201396%). PPA was higher for bacteria than for viruses, and lower PPA was largely driven by reduced detection of low-abundance or co-infecting pathogens. In an exploratory subset analysis, AveloMask results overlapped with standard-of-care testing and may have informed antimicrobial decision-making. Breath aerosol sampling using the AveloMask enabled noninvasive molecular detection of LRT pathogens in pneumonia cases and may complement conventional standard-of-care testing, particularly when sputum is unavailable.<\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>Pneumonia diagnosis often relies on sputum samples, which many patients cannot provide, or bronchoscopy, which is invasive. This study evaluated a user-friendly face mask that captures exhaled aerosols released during normal breathing and coughing for laboratory testing. In hospitalized patients with pneumonia, the mask identified the most abundant pathogen in most cases and was well tolerated in routine clinical care. These findings show that breath aerosol sampling could provide a practical, noninvasive complement to existing diagnostic methods, especially when sputum is unavailable or difficult to obtain. By making lower respiratory tract (LRT) sampling easier and more accessible, this approach could support faster, more targeted treatment decisions, reduce unnecessary antibiotic use, and expand opportunities for molecular diagnosis in hospitals and other healthcare settings.<\/jats:p>\n                      <jats:p>\n                        This study is registered with ClinicalTrials.gov as\n                        <jats:related-object xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" document-id=\"NCT06668883\" document-id-type=\"clinical-trial-number\" source-id=\"10.18810\/clinical-trials-gov\" source-id-type=\"crossref-doi\" source-type=\"clinical-trials-registry\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT06668883\">NCT06668883<\/jats:related-object>\n                        .\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/jcm.00562-26","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:11:29Z","timestamp":1789071089000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Breath aerosol PCR for detection of lower respiratory tract infections: evaluation of a non-invasive face mask collector in pneumonia patients"],"prefix":"10.1128","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3652-6859","authenticated-orcid":true,"given":"Katie","family":"Tiseo","sequence":"first","affiliation":[{"name":"Avelo AG","place":["Schlieren, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9410-7404","authenticated-orcid":true,"given":"Sarah","family":"Dr\u00e4ger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel","place":["Basel, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshitha","family":"Santhosh Kumar","sequence":"additional","affiliation":[{"name":"Avelo AG","place":["Schlieren, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1702-2308","authenticated-orcid":true,"given":"Maia","family":"Alkhazashvili","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01ks7f963","id-type":"ROR","asserted-by":"publisher"}],"name":"National Center for Disease Control and Public Health of Georgia","place":["Tbilisi, Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anya","family":"Hammann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel","place":["Basel, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0223-6685","authenticated-orcid":true,"given":"Patricia","family":"Risch","sequence":"additional","affiliation":[{"name":"Avelo AG","place":["Schlieren, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reto","family":"Willi","sequence":"additional","affiliation":[{"name":"Avelo AG","place":["Schlieren, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Mkhatvari","sequence":"additional","affiliation":[{"name":"Avicenna \u2013 Batumi Medical University, Batumi University Hospital (MedCenter)","place":["Batumi, Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Fialov\u00e1","sequence":"additional","affiliation":[{"name":"ZHAW Zurich University of Applied Sciences, School of Life Sciences and Facility Management, ZHAW University of Applied Sciences Institute of Chemistry and Biotechnology","place":["W\u00e4denswil, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4081-221X","authenticated-orcid":true,"given":"Christian","family":"Adlhart","sequence":"additional","affiliation":[{"name":"ZHAW Zurich University of Applied Sciences, School of Life Sciences and Facility Management, ZHAW University of Applied Sciences Institute of Chemistry and Biotechnology","place":["W\u00e4denswil, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel","place":["Basel, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Suknidze","sequence":"additional","affiliation":[{"name":"Avicenna \u2013 Batumi Medical University","place":["Batumi, Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izolda","family":"Pachkoria","sequence":"additional","affiliation":[{"name":"Hightechnology Hospital Medcenter","place":["Batumi, Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7959-1055","authenticated-orcid":true,"given":"Tobias","family":"Broger","sequence":"additional","affiliation":[{"name":"Avelo AG","place":["Schlieren, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2872-5161","authenticated-orcid":true,"given":"Elena","family":"Ivanova Reipold","sequence":"additional","affiliation":[{"name":"Avelo AG","place":["Schlieren, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khatuna","family":"Varshanidze","sequence":"additional","affiliation":[{"name":"Avicenna \u2013 Batumi Medical University, Batumi University Hospital (MedCenter)","place":["Batumi, Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5439-957X","authenticated-orcid":true,"given":"Michael","family":"Osthoff","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Hospital Basel","place":["Basel, Switzerland"]},{"name":"Department of Internal Medicine, Cantonal Hospital Winterthur","place":["Winterthur, Switzerland"]},{"id":[{"id":"https:\/\/ror.org\/02s6k3f65","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Research, University of Basel","place":["Basel, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(25)00689-9"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiz053"},{"key":"e_1_3_5_4_2","first-page":"194","article-title":"Vital signs: improving antibiotic use among hospitalized patients","volume":"63","author":"Fridkin S","year":"2014","unstructured":"Fridkin S, Baggs J, Fagan R, Magill S, Pollack LA, Malpiedi P, Slayton R, Khader K, Rubin MA, Jones M, Samore MH, Dumyati G, Dodds-Ashley E, Meek J, Yousey-Hindes K, Jernigan J, Shehab N, Herrera R, McDonald CL, Schneider A, Srinivasan A, Centers for Disease Control and Prevention (CDC). 2014. Vital signs: improving antibiotic use among hospitalized patients. MMWR Morb Mortal Wkly Rep 63:194\u2013200.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02037-08"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-80466-3_23"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.186.9.929"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.00379-22"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaf625"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.abd9149"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00546-25"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2021.03.018"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0843-2"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2021.115589"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac202"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2023.03.029"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-024-00737-8"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(22)00086-8"},{"key":"e_1_3_5_19_2","unstructured":"R Core Team. 2025. R: a language and environment for statistical computing. R Foundation for Statistical Computing Vienna Austria."},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.03.024"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0200531"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2022.114417"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2022.09.003"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.121.5.1486"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-0803-5"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy010"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(24)00148-7"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2026.106683"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.02111-25"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00128-20"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00343-20"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(23)00101-5"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bios.2022.114663"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2026.03.024"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiag206"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-023-02080-1"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-025-03032-6"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofx014"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2012.022"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.00562-26","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/jcm.00562-26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T19:17:09Z","timestamp":1793128629000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/jcm.00562-26"}},"subtitle":[],"editor":[{"given":"John P.","family":"Dekker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":38,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,14]]}},"alternative-id":["10.1128\/jcm.00562-26"],"URL":"https:\/\/doi.org\/10.1128\/jcm.00562-26","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"assertion":[{"value":"2026-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00562-26"}}