用于检测耐药结核性脑膜炎的靶向新一代测序技术（tNGS）：这项测序技术是否已准备就绪？

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology Pub Date : 2024-07-11 DOI:10.1016/j.ijmmb.2024.100665

Priti Kambli , Kanchan Ajbani , Amala A. Andrews , Shaoli Basu , Anjali Shetty , Tanvi Patil , Ishita Mehta , Harpreet Singh , Camilla Rodrigues

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引用次数: 0

摘要

目的：结核性脑膜炎（TBM）是结核病（TB）中最严重的一种。该病诊断困难，加上其他因素，增加了其高发病率和高死亡率的可能性。靶向下一代测序（tNGS）能产生高质量的序列深度读数，从而鉴定出与耐药性（DR）相关的低频等位基因。结核性脑膜炎的贫弱性是明确诊断的一个挑战。方法：对 20 份 MGIT 显示 MTB 培养阳性的脑脊液（CSF）样本进行了 tNGS 测序。我们同时对这 20 份样本进行了热测序（PSQ）和表型药敏试验（pDST）：结果：测序结果（tNGS 和 PSQ）与参考标准（即 pDST）进行了比较。tNGS 在 7/20 份 CSF 样本（35%）中检测到 MTB，而 PSQ 在 17/20 份 CSF 样本（85%）中检测到 MTB：尽管与 PSQ 相比，tNGS 能够检测出少数变异株和更多目标，但 PSQ 仍是我们三级实验室的诊断选择。

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Targeted Next Generation Sequencing (tNGS) for detection of drug-resistant tuberculous meningitis: Is this sequencing technology ready for prime time?

Purpose

Tuberculous meningitis (TBM) is the most severe form of tuberculosis (TB). Difficulty in diagnosing the condition along with other factors, increases its potential for high morbidity and mortality. Targeted Next Generation Sequencing (tNGS) generates high quality sequence read depths, enabling the identification of low-frequency alleles linked to Drug resistance (DR). The paucibacillary nature of tuberculous meningitis is a challenge for making a definitive diagnosis.

Methods

tNGS was performed on 20 cerebrospinal fluid (CSF) samples where, MGIT has shown Positive MTB Cultures. We simultaneously performed pyrosequencing (PSQ) and phenotypic Drug susceptibility testing (pDST) for these 20 samples.

Results

Sequencing results (from tNGS and PSQ) were compared with reference standards i.e. pDST. tNGS detected MTB in 7/20 (35%) CSF samples whereas, PSQ detected MTB in 17/20 (85%).

Conclusion

Although tNGS has ability to detect minority variants along with detection of additional targets than PSQ, PSQ remains the diagnostic choice in our tertiary lab.

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来源期刊

Indian Journal of Medical Microbiology IMMUNOLOGY-

CiteScore

2.20

自引率

0.00%

发文量

154

审稿时长

73 days

期刊介绍： Manuscripts of high standard in the form of original research, multicentric studies, meta analysis, are accepted. Current reports can be submitted as brief communications. Case reports must include review of current literature, clinical details, outcome and follow up. Letters to the editor must be a comment on or pertain to a manuscript already published in the IJMM or in relation to preliminary communication of a larger study. Review articles, Special Articles or Guest Editorials are accepted on invitation.