12.01.2026
Non-invasive diagnosis of tuberculosis from respiratory masks
The diagnosis of pulmonary tuberculosis (TB) has so far been based primarily on sputum samples. However, not all patients are able to produce sufficient sputum. A recently published prospective study shows that face mask sampling (FMS) could be a promising, non-invasive addition to existing diagnostic methods. The manuscript was published in the journal Clinical Microbiology and Infection (CMI).
The study was conducted at the Chiril Draganiuc Institute of Pneumology in Chișinău, Republic of Moldova, under the direction of Assoc. Prof. Dumitru Chesov and Dr. Thomas Theo Brehm from the Clinical Infectious Diseases Research Group at the Research Center Borstel, in collaboration with local partners. The first author, medical student Dariusz Wölk from the University Medical Center Hamburg-Eppendorf, traveled to Chisinau for a year for this purpose. The doctoral program was funded by an MD scholarship from the German Center for Infection Research (DZIF).
Over the course of a year, 117 adult patients with suspected or confirmed pulmonary tuberculosis were examined. During face mask sampling, participants wore specially adapted FFP2 masks that were manufactured at the Research Center Borstel itself. The idea came from Lennard Meiwes, a medical student at the University of Lübeck and also a DZIF MD scholarship holder, who conducted similar studies last year to diagnose pulmonary tuberculosis in children in the Republic of Moldova. In order to prepare commercially available FFP2 masks with strips of polyvinyl alcohol (PVA), the group purchased a 3D printer on eBay. The printed PVA strips were then attached to the inside of the masks. They serve to capture genetic material (DNA) from tuberculosis bacteria in the air we breathe. After wearing, the PVA strips were removed from the masks, dissolved, and then analyzed for the presence of genetic material using the Xpert MTB/RIF Ultra rapid molecular test.
In almost 60% of microbiologically confirmed cases, bacterial DNA was detected in the mask samples. The additive benefit is particularly relevant: In 6% of patients diagnosed with pulmonary tuberculosis through cultural detection of the pathogen in sputum, molecular genetic detection of tuberculosis bacteria DNA was possible exclusively from the mask, but not from the sputum. This means that the procedure could provide additional, rapidly available diagnostic information that would not have been obtained using established methods alone.
"Our data show that face mask sampling can have relevant additional benefits in selected clinical situations: In about one in 18 people with pulmonary tuberculosis, tuberculosis bacteria could be detected in the FFP2 mask, but not in the sputum. This means that the procedure could be a useful addition to established tuberculosis diagnostics. Face mask sampling is thus one of a growing number of new, non-invasive diagnostic approaches that have the potential to improve the early identification of tuberculosis and quickly bring additional patients into therapy," comments Dr. Thomas Theo Brehm, one of the last authors of the study from the DZIF ClinTB infrastructure at the Research Center Borstel.
Kontakt
Prof. Dr. med. Dr. h.c. Christoph Lange DZIF TTU TB (ClinTB)
T +49 4537 / 188-3010 (Sekretariat)
F +49 4537 / 188-6030
clange@fz-borstel.de
Publication: Woelk D, Meiwes L, Ciobanu N, Crudu V, Comanac AM, Kulcitkaia S, Vasiliu A, Mandalakas AM, Lange C, Brehm TT, Chesov D. Non-invasive diagnosis of pulmonary tuberculosis using face mask sampling: A prospective study in adults. Clin Microbiol Infect 2025 (online ahead of print) https://doi.org/10.1016/j.cmi.2025.12.017