Stool microbiome reveals diverse bacterial ureases as confounders of oral urea breath testing for Helicobacter pylori and Mycobacterium tuberculosis in Bamako, Mali

Mamoudou Maiga, Keira Cohen, Bocar Baya, Geetha Srikrishna, Sophia Siddiqui, Moumine Sanogo, Anou M. Somboro, Bassirou Diarra, Mariam H. Diallo, Varun Mazumdar, Christian Yoder, Susan Orsega, Michael Belson, Hamadoun Kassambara, Drissa Goita, Robert L. Murphy, Sounkalo Dao, Michael Polis, Souleymane Diallo, Graham S. TimminsLori Dodd, Ashlee M. Earl, William R. Bishai*

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Detection of bacterial urease activity has been utilized successfully to diagnose Helicobacter pylori (H. pylori). While Mycobacterium tuberculosis (M. tuberculosis) also possesses an active urease, it is unknown whether detection of mycobacterial urease activity by oral urease breath test (UBT) can be exploited as a rapid point of care biomarker for tuberculosis (TB) in humans. We enrolled 34 individuals newly diagnosed with pulmonary TB and 46 healthy subjects in Bamako, Mali and performed oral UBT, mycobacterial sputum culture and H. pylori testing. Oral UBT had a sensitivity and specificity (95% CI) of 70% (46-88%) and 11% (3-26%), respectively, to diagnose culture-confirmed M. tuberculosis disease among patients without H. pylori, and 100% sensitivity (69-100%) and 11% specificity (3-26%) to diagnose H. pylori among patients without pulmonary TB. Stool microbiome analysis of controls without TB or H. pylori but with positive oral UBT detected high levels of non-H. pylori urease producing organisms, which likely explains the low specificity of oral UBT in this setting and in other reports of oral UBT studies in Africa.

Original languageEnglish (US)
Article number036012
JournalJournal of Breath Research
Volume10
Issue number3
DOIs
StatePublished - Aug 17 2016

Keywords

  • H. pylori
  • TB
  • oral urease breath test
  • urease

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Maiga, M., Cohen, K., Baya, B., Srikrishna, G., Siddiqui, S., Sanogo, M., Somboro, A. M., Diarra, B., Diallo, M. H., Mazumdar, V., Yoder, C., Orsega, S., Belson, M., Kassambara, H., Goita, D., Murphy, R. L., Dao, S., Polis, M., Diallo, S., ... Bishai, W. R. (2016). Stool microbiome reveals diverse bacterial ureases as confounders of oral urea breath testing for Helicobacter pylori and Mycobacterium tuberculosis in Bamako, Mali. Journal of Breath Research, 10(3), [036012]. https://doi.org/10.1088/1752-7155/10/3/036012