THE DIAGNOSIS OF PULMONARY TUBERCULOSIS BY GASCHROMATOGRAPHIC DETECTION OF TUBERCULOSTEARIC ACID USING FLAME IONIZATION DETECTORS

It has been shown that the detection of tuberculostearic acid (TBSA) w ith gas chromatography-massspectrometry provides a highly specific, se nsitive and rapid method for the diagnosis of various forms of tubercu losis. However, the need for complex and expensive equipment prevented the more widespread use of this method. We report on the application of conventional gas chromatography with flame ionization detectors in the detection of TBSA in sputum samples. TBSA was detected in all pati ents with proven pulmonary tuberculosis before treatment or under trea tment for less than 4 weeks (n = 18). Six of these patients (33%) had a negative microscopy result at the time of the study. Sputum samples from patients under therapy for longer than 4 weeks (n = 20) were TBSA -positive in 15 cases (75%). Only in two cases was the diagnosis by mi croscopy and/or cultur not met by TBSA-detection. All sputa of 20 cont rol patients with lung diseases other than tuberculosis were TBSA nega tive. Additional analysis of patients' data showed a significant relat ionship (P < O.005) between the relative amounts of TBSA detectable in the sputum samples and the duration of therapy. It is concluded that conventional capillary gaschromatography may be sensitive and specific enough to be used for the detection of TBSA in sputum of patients wit h pulmonary tuberculosis.