Drug Discov Ther. 2026;20(2):147-154. (DOI: 10.5582/ddt.2025.01123)

Cytoderm metabolic-labeling SCMLP-TB for pulmonary tuberculosis diagnosis: A preliminary diagnostic accuracy study

Liang GY, Dai GQ, Hu XR, Liu DL, Lin ZQ, Yang MR, He ZJ, Chen PF, Liu YP, Jia XY, Dai XF, Zhao PF, Zheng MB, Zhou Y, Lu HZ

Tuberculosis (TB) remains a significant global health issue. Early diagnosis is crucial, yet current diagnostic technologies are limited by suboptimal sensitivity. Thus, we developed a novel tuberculosis metabolic labeling probe (single cell metabolic labeling probe for tuberculosis, SCMLP-TB) and evaluated its diagnostic performance. In this retrospective study of 70 suspected TB patients, we calculated the sensitivity and specificity of SCMLP-TB and compared it with culture and Xpert MTB/RIF (Xpert) using the final clinical diagnosis as reference standard. Eligible participants were classified as confirmed TB (CT), clinically diagnosed TB (CDxT), or non-TB cases based on the diagnosis criteria for pulmonary tuberculosis (WS 288-2017). Of the 70 participants, 40 (57.0%) were diagnosed with TB, including 30 CT cases and 10 CDxT cases. The overall diagnostic sensitivity and specificity of SCMLP-TB were 97.5% and 96.7%, respectively. Notably, SCMLP-TB identified 10 CDxT cases missed by both culture and Xpert. The overall diagnostic sensitivity of culture and Xpert was 62.5% and 72.5%, respectively, while both showed a specificity of 100.0%, demonstrating that SCMLP-TB was more sensitive than culture and Xpert. Besides, the fluorescence intensity from TB patients was significantly higher than non-TB patients. The fluorescence intensity showed a significant negative correlation with the time to positivity (TTP) of culture, which suggested that SCMLP-TB could also serve as an indicator of bacterial loads in patients' samples. Consequently, SCMLP-TB demonstrated a promising tool for the sensitive and ultra-fast diagnosis of pulmonary TB suspects, particularly for paucibacillary pulmonary TB.

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