Broadening the diagnostic landscape of Mycobacterium tuberculosis infection: analyzing exhaled breath

Abstract Mycobacterium tuberculosis is a deadly infectious agent that infects over 10 million people every year. Early detection of Mycobacterium tuberculosis infection is essential for effective treatment and reduction of emerging drug resistance. However, current diagnostic methods are limited by lengthy procedures, invasive sampling or low sensitivity. Especially in the case of HIV co-infection, pediatric patients, extrapulmonary tuberculosis (TB) and drug-resistant TB, obtaining adequate samples and detecting and treating TB is challenging. Breath analysis is an alternative tool for TB diagnosis that can potentially overcome the limitations associated with conventional techniques. Nevertheless, TB breath tests are still in their infancy. This review provides an overview of recent advances in breath analysis for TB detection. We discuss the different biomarkers found for TB detection in exhaled breath and their strengths and limitations for the disease diagnostics. We conclude that breath analysis could be a promising TB diagnosis tool, calling for standardization of breath collection and validation of data obtained with various analysis techniques to ensure both sensitivity and specificity required in practice.