Nanopore-targeted sequencing (NTS) for intracranial tuberculosis: a promising and reliable approach.

IF 4.6 2区 医学 Q1 MICROBIOLOGY
Chen Yang, Tianzhen Wang, Yicheng Guo, Yi Zeng, Weiwei Gao
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引用次数: 0

Abstract

Background: The World Health Organization predicted 10.6 million new tuberculosis cases and 1.5 million deaths in 2022. Tuberculous meningitis, affecting 1% of active TB cases, is challenging to diagnose due to sudden onset, vague symptoms, and limited laboratory tests. Nanopore-targeted sequencing (NTS) is an emerging third-generation sequencing technology known for its sequencing capabilities. We compared its detection efficiency with Xpert, MTB culture, PCR, and AFB smear in cerebrospinal fluid samples to highlight the substantial potential of NTS in detecting intracranial tuberculosis.

Methods: This study included 122 patients suspected of having intracranial tuberculosis at the Second Hospital of Nanjing in Jiangsu Province, China, between January 2021 and January 2024. The Univariate logistic regression and random forest regression identified risk factors and clinical markers. A chi-square test evaluated diagnostic accuracy for different image types of intracranial tuberculosis.

Results: The research involved 100 patients with intracranial tuberculosis. Among them, 41 had tuberculous meningitis, 27 had cerebral parenchymal tuberculosis, and 32 had mixed intracranial tuberculosis. Besides, 22 patients were diagnosed with other brain conditions. In diagnosing intracranial tuberculosis, NTS demonstrated a sensitivity of 60.0% (95% CI: 49.7-69.5%) and a specificity of 95.5% (95% CI:75.1-99.8%), with an AUC value of 0.78 (95% CI: 0.71 to 0.84), whose overall performance was significantly better than other detection methods. There was no notable difference (P > 0.05) in diagnostic accuracy between NTS and the final diagnosis for intracranial tuberculosis patients with varying imaging types. Furthermore, patients who tested positive had a 31.500 (95% CI: 6.205-575.913) times higher risk of having intracranial tuberculosis compared to those with negative results.

Conclusion: Due to its convenience, efficiency, quick turnaround time, and real-time sequencing analysis, NTS might become a promising and reliable method for providing microbiological diagnoses for patients with intracranial tuberculosis and for screening populations at risk.

颅内结核病的纳米孔靶向测序(NTS):一种前景广阔的可靠方法。
背景:世界卫生组织预测,2022 年将新增 1060 万例结核病病例和 150 万例死亡病例。结核性脑膜炎占活动性肺结核病例的 1%,由于发病突然、症状模糊、实验室检测手段有限,诊断难度很大。纳米孔靶向测序(NTS)是一种新兴的第三代测序技术,以其测序能力著称。我们比较了它与 Xpert、MTB 培养、PCR 和 AFB 涂片在脑脊液样本中的检测效率,以突出 NTS 在检测颅内结核病方面的巨大潜力:本研究纳入了 2021 年 1 月至 2024 年 1 月期间江苏省南京市第二医院的 122 例颅内结核疑似患者。单变量逻辑回归和随机森林回归确定了风险因素和临床标记物。通过卡方检验评估了不同影像类型颅内结核的诊断准确性:研究涉及 100 名颅内结核患者。其中,41 例为结核性脑膜炎,27 例为脑实质结核,32 例为颅内混合型结核。此外,还有 22 名患者被诊断为其他脑部疾病。在诊断颅内结核方面,NTS 的灵敏度为 60.0%(95% CI:49.7-69.5%),特异度为 95.5%(95% CI:75.1-99.8%),AUC 值为 0.78(95% CI:0.71-0.84),其整体性能明显优于其他检测方法。对于不同影像学类型的颅内结核患者,NTS 与最终诊断结果的诊断准确率没有明显差异(P > 0.05)。此外,与阴性结果的患者相比,检测结果呈阳性的患者罹患颅内结核的风险要高出31.500倍(95% CI:6.205-575.913):由于 NTS 方便、高效、周转时间快且可进行实时测序分析,它可能会成为为颅内结核病患者提供微生物诊断和筛查高危人群的一种有前途且可靠的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.60
自引率
0.00%
发文量
49
审稿时长
>12 weeks
期刊介绍: Annals of Clinical Microbiology and Antimicrobials considers good quality, novel and international research of more than regional relevance. Research must include epidemiological and/or clinical information about isolates, and the journal covers the clinical microbiology of bacteria, viruses and fungi, as well as antimicrobial treatment of infectious diseases. Annals of Clinical Microbiology and Antimicrobials is an open access, peer-reviewed journal focusing on information concerning clinical microbiology, infectious diseases and antimicrobials. The management of infectious disease is dependent on correct diagnosis and appropriate antimicrobial treatment, and with this in mind, the journal aims to improve the communication between laboratory and clinical science in the field of clinical microbiology and antimicrobial treatment. Furthermore, the journal has no restrictions on space or access; this ensures that the journal can reach the widest possible audience.
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