International Journal of Molecular and Cellular Medicine (IJMCM)

Metabolomics, the comprehensive analysis of small-molecule metabolites within biological systems, has emerged as a powerful analytical platform for advancing the diagnosis, prognosis, and management of infectious diseases. Leveraging high-throughput technologies such as mass spectrometry (MS) and nuclear magnetic resonance (NMR), metabolomics enables the identification of distinct metabolic fingerprints associated with infections, offering novel metabolomic insights host-pathogen interactions and disease pathophysiology. MS-based platforms, coupled with chromatographic techniques like gas chromatography (GC-MS) and liquid chromatography (LC-MS), provide exceptional sensitivity and specificity for metabolite detection in biofluids such as blood, urine, and cerebrospinal fluid (CSF). NMR spectroscopy complements these approaches by enabling non-destructive, reproducible analyses ideal for longitudinal studies and treatment monitoring. In infectious disease diagnostics, metabolomics has demonstrated the ability to differentiate bacterial, viral, and fungal infections through unique metabolic signatures. For example, bacterial sepsis is characterized by significant perturbations in lipid metabolism, including alterations in phospholipids and sphingolipids, which correlate with systemic inflammation and immune activation. Beyond diagnostics, metabolomics contributes to understanding antimicrobial resistance (AMR) by profiling metabolic reprogramming in resistant strains, revealing mechanisms such as increased efflux pump activity, biofilm formation, and membrane remodeling. These insights present potential therapeutic targets and inform personalized treatment strategies. The integration of metabolomics with genomics and proteomics further enhances diagnostic and prognostic accuracy. This review details metabolomics applications in sepsis, meningitis, tuberculosis (TB), respiratory tract infections (RTIs), UTIs, and Helicobacter pylori (H. pylori) infections, emphasizing its potential to revolutionize infection management while discussing current challenges and future directions.