Diagnosis of pulmonary tuberculosis by selected-ion monitoring: improved analysis of tuberculostearate in sputum using negative-ion mass spectrometry.

Coded sputum specimens from patients with tuberculous (8 specimens) and nontuberculous (15 specimens) pneumonia were analyzed for tuberculostearic acid by selected-ion monitoring of the pentafluorobenzyl ester derivative by using negative-ion mass spectrometry. The analytical results agreed with those from culturing of the specimens, except in three cases in which the chromatograms were difficult to interpret owing to insufficient amounts of sputa available. Negative-ion mass spectrometry provided superior sensitivity and selectivity for detection of tuberculostearic acid compared with the previously used gas chromatographic-mass spectrometric methods. The technique reported here should have considerable potential for the rapid diagnosis of pulmonary tuberculosis by direct analysis of sputum.