Rapid diagnosis of TB using GC-MS and chemometrics

The search continues for a rapid diagnostic test for TB that has high sensitivity and specificity and is useable in sophisticated environments and in deprived regions with poor infrastructure. We discuss here the modern bioanalytical techniques that can be used to discover biomarkers of infection with Mycobacterium tuberculosis, focusing on techniques using GC. We will also discuss the use of GC-MS to identify volatile organic compounds in the headspace of bacterial culture or in samples of breath, serum or urine. Biomarkers discovered in the 'clean' environment of culture may differ from those in patients. A number of biomarkers have been found in patients, with little consistency in the various studies to date. Reproducibility is difficult; the impressive results found initially with a few patients are rarely repeatable when a larger sample series is tested. Mycobacterial lipids offer promise for distinguishing M. tuberculosis from nontuberculous mycobacteria directly in sputum.