Breath analysis as a potential diagnostic tool for tuberculosis
Abstract:SETTING: Cape Town, South Africa.
OBJECTIVES: We investigated the potential of breath analysis by gas chromatography-mass spectrometry (GC-MS) to discriminate between samples collected prospectively from patients with suspected tuberculosis (TB).
DESIGN: Samples were obtained in a TB-endemic setting in South Africa, where 28% of culture-proven TB patients had Ziehl-Neelsen (ZN) negative sputum smear. A training set of breath samples from 50 sputum culture-proven TB patients and 50 culture-negative non-TB patients was analysed using GC-MS. We used support vector machine analysis for classification of the patient samples into TB and non-TB.
RESULTS: A classification model with seven compounds had a sensitivity of 72%, a specificity of 86% and an accuracy of 79% compared with culture. The classification model was validated with breath samples from a different set of 21 TB and 50 non-TB patients from the same area, giving a sensitivity of 62%, a specificity of 84% and an accuracy of 77%.
CONCLUSION: This study shows that GC-MS breath analysis is able to differentiate between TB and non-TB breath samples even among patients with a negative ZN sputum smear but a positive culture for Mycobacterium tuberculosis. We conclude that breath analysis by GC-MS merits further research.
Document Type: Research Article
Affiliations: 1: KIT Biomedical Research, Royal Tropical Institute, Amsterdam, The Netherlands; and Analytical Chemistry and Forensic Science, Van 't Hoff Institute for Molecular Sciences, University of Amsterdam, Amsterdam, The Netherlands 2: Department of Toxicology, Research Institute NUTRIM, Maastricht University, Maastricht, The Netherlands 3: Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg, Cape Town, South Africa 4: KIT Biomedical Research, Royal Tropical Institute, Amsterdam, The Netherlands; Analytical Chemistry and Forensic Science, Van 't Hoff Institute for Molecular Sciences, University of Amsterdam, Amsterdam, The Netherlands
Publication date: June 1, 2012
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