纳米孔靶向测序技术在亚临床结核病诊断中的应用价值

Abstract

Background Subclinical Tuberculosis (TB), with low bacterial loads and non-specific symptoms, is difficult to diagnose and promotes transmission. This study aimed to evaluate the diagnostic performance of nanopore-based targeted sequencing (NTS) for subclinical TB in comparison with Mycobacteria Growth Indicator Tube (MGIT) culture and GeneXpert MTB/RIF (Xpert MTB/RIF) assays. Methods This retrospective research included 103 subclinical TB suspects. We tested sputum, bronchoalveolar lavage fluid, or pleural effusion from each patient using NTS, MGIT culture, and Xpert. Diagnostic performance was assessed using a composite standard. Results NTS exhibited higher sensitivity (90.9%) than MGIT culture (40.9%) and Xpert MTB/RIF (50.0%). It had a larger area under the curve (AUC) of 0.923 than Xpert (0.731) and MGIT culture (0.667), as well as an impressive negative predictive value (97.4%) and accuracy (93.2%). Conclusion NTS efficiently identifies subclinical TB cases with low bacterial burdens using the composite diagnostic criteria, outperforming conventional methods. It could detect TB early, closing the gap in TB control.