Identification of Mycobacterium tuberculosis using volatile biomarkers in culture and exhaled breath

In this pilot study, volatile molecules produced by cultures of Mycobacterium tuberculosis were evaluated to determine whether they could be used to discriminate between uninfected and M. tuberculosis-infected macaques. Thirty seven of the culture biomarkers were detectable in macaque breath and were shown to discriminate between uninfected and infected animals with an area under the curve (AUC) of 87%. An AUC of 98% was achieved when using the top 38 discriminatory molecules detectable in breath. We report two newly discovered volatile biomarkers, not previously associated with M. tuberculosis, that were selected in both our in vitro and in vivo discriminatory biomarker suites: 4-(1,1-dimethylpropyl) phenol and 4-ethyl-2,2,6,6-tetramethylheptane. Additionally, we report the detection of heptanal, a previously identified M. tuberculosis breath biomarker in humans, as an in vitro culture biomarker that was detected in every macaque breath sample analyzed, though not part of the in vivo discriminatory suite. This pilot study suggests that molecules from the headspace of M. tuberculosis culture show potential to translate as breath biomarkers for macaques infected with the same strain.