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Breath analysis as a potential diagnostic tool for tuberculosis

Kolk, A. H. J.; van Berkel, J. J. B. N.; Claassens, M. M.; Walters, E.; Kuijper, S.; Dallinga, J. W.; van Schooten, F. J.

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PMID: 22507235


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.

Automatic Tags

Female; Humans; Male; Adult; Young Adult; Middle Aged; Prospective Studies; Predictive Value of Tests; Sensitivity and Specificity; Breath Tests; Reproducibility of Results; South Africa; Gas Chromatography-Mass Spectrometry; Tuberculosis; Endemic Diseases; Mycobacterium tuberculosis; Sputum; Support Vector Machine

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