Experimental system enables studies of <i>Mycobacterium tuberculosis</i> during aerogenic transmission

Tuberculosis is transmitted when exhaled <i>Mycobacterium tuberculosis</i> (Mtb)-laden microdroplets of an infected individual are inhaled by a susceptible person. Historically, studies on Mtb transmission have focused mainly on epidemiology due to the technical challenges in replicating the transmission process effectively in a laboratory setting. In this study, we introduce a transmission simulation system (TSS) that integrates controlled Mtb aerosolization, biophysical aerosol particle measurements, in-flight Mtb sampling, and aerosol infection of mice. The TSS generated Mtb bioaerosol concentrations comparable to those produced by human coughs. These pathogen droplets were accurately deposited in mouse lungs at low Mtb doses relevant to human transmission. Notably, the distribution of Mtb among aerosol particles of various sizes closely mirrored that found in the coughs of tuberculosis patients. In summary, the TSS represents a novel tool for conducting molecular studies of Mtb transmission through the air.