Detection and Differentiation of Bacterial and Fungal Infection of Neutrophils from Peripheral Blood Using Raman Spectroscopy.

ABSTRACT

Neutrophils are important cells of the innate immune system and the major leukocyte subpopulation in blood. They are responsible for recognizing and neutralizing invading pathogens, such as bacteria or fungi. For this, neutrophils are well equipped with pathogen recognizing receptors, cytokines, effector molecules, and granules filled with reactive oxygen species (ROS)-producing enzymes. Depending on the pathogen type, different reactions are triggered, which result in specific activation states of the neutrophils. Here, we aim to establish a label-free method to indirectly detect infections and to identify the cause of infection by spectroscopic characterization of the neutrophils. For this, isolated neutrophils from human peripheral blood were stimulated in an in vitro infection model with heat-inactivated Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) bacterial pathogens as well as with heat-inactivated and viable fungi (Candida albicans). Label-free and nondestructive Raman spectroscopy was used to characterize neutrophils on a single cell level. Phagocytized fungi could be visualized in a few high-resolution false color images of individual neutrophils using label-free Raman spectroscopic imaging. Using a high-throughput screening Raman spectroscope (HTS-RS), Raman spectra of more than 2000 individual neutrophils from three different donors were collected in each treatment group, yielding a data set of almost 20 000 neutrophil spectra. Random forest classification models were trained to differentiate infected and noninfected cells with high accuracy (90%). Among the neutrophils challenged with pathogens, even the cause of infection, bacterial or fungal, was predicted correctly with 92% accuracy. Therefore, Raman spectroscopy enables reliable neutrophil phenotyping and infection diagnosis in a label-free manner. In contrast to the microbiological diagnostic standard, where the pathogen is isolated in time-consuming cultivation, this Raman-based method could potentially be blood-culture independent, thus saving precious time in bloodstream infection diagnostics.