Validation of biomarkers for distinguishing Mycobacterium tuberculosis from non-tuberculous mycobacteria using gas chromatography-mass spectrometry and chemometrics

PLoS One. 2013 Oct 17;8(10):e76263. doi: 10.1371/journal.pone.0076263. eCollection 2013.

Abstract

Tuberculosis (TB) remains a major international health problem. Rapid differentiation of Mycobacterium tuberculosis complex (MTB) from non-tuberculous mycobacteria (NTM) is critical for decisions regarding patient management and choice of therapeutic regimen. Recently we developed a 20-compound model to distinguish between MTB and NTM. It is based on thermally assisted hydrolysis and methylation gas chromatography-mass spectrometry and partial least square discriminant analysis. Here we report the validation of this model with two independent sample sets, one consisting of 39 MTB and 17 NTM isolates from the Netherlands, the other comprising 103 isolates (91 MTB and 12 NTM) from Stellenbosch, Cape Town, South Africa. All the MTB strains in the 56 Dutch samples were correctly identified and the model had a sensitivity of 100% and a specificity of 94%. For the South African samples the model had a sensitivity of 88% and specificity of 100%. Based on our model, we have developed a new decision-tree that allows the differentiation of MTB from NTM with 100% accuracy. Encouraged by these findings we will proceed with the development of a simple, rapid, affordable, high-throughput test to identify MTB directly in sputum.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Algorithms
  • Biomarkers / metabolism*
  • Discriminant Analysis
  • Gas Chromatography-Mass Spectrometry / methods*
  • Humans
  • Hydrolysis
  • Least-Squares Analysis
  • Methylation
  • Mycobacterium tuberculosis / isolation & purification*
  • Netherlands
  • Nontuberculous Mycobacteria / isolation & purification*
  • Reproducibility of Results
  • South Africa
  • Temperature

Substances

  • Biomarkers

Grants and funding

This work was supported by the UBS Optimus Foundation and NanoNextNL, a micro and nanotechnology consortium of the Government of the Netherlands and 130 partners. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.