Compositions for identifying a pathogenic bacterial infection include a
mannitol compound with one or more substituents including radioisotopes. These radiopharmaceuticals, such as a
positron-emitting
mannitol analogue, [18F]fluoromannitol ([18F]FMtl), are rapidly taken up by
gram-positive and
gram-negative
bacteria such as E. coli, S. aureus, A. baumannii, S. epidermis, P. mirabilis, S. enterica, K. pneumonia, E. faecium, E. cloacae, and M. marinum, but not non-active infection sites such as sterile inflammatory sites,
cancer sites, etc. Administration of these radiopharmaceuticals to and subsequent imaging of patients, e.g., via
positron emission
tomography (PET), enables detection of deep-seated and difficult to manage bacterial infections, such as
osteomyelitis and
prosthetic joint infection, or in patients with sickle
cell disease. [18F]FMtl injection detects and differentiates infection rapidly. The radiolabeled
mannitol compounds can be produced via
nucleophilic substitution reactions that are deployable on commercially available synthesizers, facilitating straightforward and wide
accessibility, and counteracting unnecessary
antibiotic use.