Objectives: Several studies associated altered gut microbiota composition in preterm infants with late-onset sepsis (LOS), up to days prior to clinical onset of sepsis. However, microbiota analysis as early diagnostic biomarker is in clinical practice currently not feasible because of logistic aspects and high costs. Therefore, we hypothesized that analysis of fecal volatile organic compounds (VOC) may serve as non-invasive biomarker to predict LOS at a preclinical stage, since VOC reflect the composition and activity of intestinal microbial communities. Methods: In a prospective multicenter study, fecal samples were collected daily from infants with a gestational age of
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