A Mycobacterium tuberculosis fingerprint in human breath allows tuberculosis detection

An estimated one-third of tuberculosis (TB) cases go undiagnosed or unreported, with sputum-based diagnostics performing poorly in children and paucibacillary patients. In this proof-of-concept study, we tested whether exhaled breath condensate (EBC) enables detection of pulmonary TB. We show that Mycobacterium tuberculosis (Mtb)-specific molecules, including lipoarabinomannan (LAM), characteristic lipids, and proteins, are detectable in EBC and differentiate TB patients from healthy controls and non-TB pneumonia cases. EBC enabled longitudinal monitoring of pediatric patients under antibiotic treatment. Structural analyses revealed that Mtb lipoprotein analogs and lipids in EBC differ from those of ex vivo cultured bacteria, indicating distinct metabolic/biochemical states of Mtb in the human lung. These findings support EBC as an affordable, rapid, non-invasive matrix for TB diagnosis and treatment monitoring, with potential for point-of-care implementation.

Sergio Fabián Mosquera-Restrepo, Sophie Zuberoigïta, Lucie Couvettes, Emilie Laye, Martine Gillon, Alexandre Stella, David Rengel, Odile Burlet-Schiltz, Ana Cecilia Caro, Luis F. Garcia, César Segura, Carlos Alberto Peláez Jaramillo, Mauricio Rojas, Jérôme Nigou