Instrument designed for biological pathogen monitoring can detect tuberculosis surrogate

17-Jul-2008

An instrument originally designed for detecting the malicious use of biological pathogens has potential for use in the public health sector to rapidly screen people for tuberculosis. In experiments over the past year, a research team at Lawrence Livermore National Laboratory has used their system to detect a tuberculosis surrogate, even when it is surrounded by sputum and mucus-like substances. They also were able to differentiate between two similar bacteria, distinguishing between an avirulent strain of tuberculosis and a similar bacterium, Mycobacterium semegmatis. Their research, using a system called Single-Particle Aerosol mass spectrometry, or SPAMS, is described in analytical chemistry.

"Without reagents, we can rapidly detect a virulent tuberculosis that is coated in sputum-like materials and we can distinguish between two similar mycobacteria," said Kristl Adams, a LLNL postdoctoral biological physicist and the paper's lead author. "The reason we used two similar mycobacteria in our research is that tuberculosis-like symptoms in a patient could be caused by many bacterial infections, not just tuberculosis. So we would like to differentiate between non-tuberculosis and tuberculosis infections."

"There is no current method for screening potential tuberculosis patients within minutes," said LLNL physicist and co-author Matthias Frank, who added that the "gold standard" diagnostic tool of culturing samples can require days to weeks. Other methods of diagnosing the disease, which each have advantages and disadvantages, are bacteria staining and counting in a sputum smear, DNA amplification using polymerase chain reaction and chest X-rays.

In one retrospective four-month study conducted in an urban Los Angeles hospital emergency department, it was found that more than 40 percent of patients who were later found to have tuberculosis were either initially released or not isolated. The same study also determined that resources were wasted in unneeded precautions taken for patients who, in the end, did not have tuberculosis. For every tuberculosis-positive patient, 624 patients were screened and other steps for those patients included taking 130 chest X-rays and placing 22 patients in isolation.

"It is clear," said Adams, "that a rapid tuberculosis screening technique could facilitate early detection and limit unnecessary isolation, thus providing better patient care and reducing the toll on health care facility resources."

While emphasizing that their work is only a first step toward using SPAMS for tuberculosis diagnostics, Frank and Adams said they believe SPAMS could potentially detect the disease within five minutes with concentrated samples.

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