Diagnostic value of probe capture-based targeted next-generation sequencing and metagenomic next-generation sequencing for detecting Mycobacterium tuberculosis in bronchoalveolar lavage fluid

doi:10.19982/j.issn.1000-6621.20240448

Abstract

Abstract:

Objective: To explore the diagnostic value of probe capture-based targeted next-generation sequencing (tNGS) and metagenomic next-generation sequencing (mNGS) in bronchoalveolar lavage fluid for detection of pulmonary tuberculosis. Methods: A retrospective study was conducted from the bronchoalveolar lavage fluid of 117 presumed pulmonary tuberculosis patients admitted to the Tuberculosis Department of Anhui Provincial Hospital during June 2023 to March 2024 was retrospectively analyzed. The patients received tNGS, mNGS, acid fast bacilli smear microscopy, culture and Xpert MTB/RIF. The performance of tNGS and mNGS for detection of Mycobacterium tuberculosis was evaluated. Results: Among 117 suspected tuberculosis patients, 71 patients (60.68%) were diagnosed with pulmonary tuberculosis, while 46 cases (39.32%) were non tuberculosis patients. The sensitivity of mNGS, tNGS,smear combined with culture, smear combined with culture and Xpert MTB/RIF were 77.46% (55/71), 76.06% (54/71), 34.29% (24/70) and 54.93% (39/71) respectively. The specificity were 100.00% (46/46), 95.65% (44/46), 95.65% (44/46) and 95.65% (44/46). The positive predictive values were 100.00% (55/55), 96.43% (54/56), 92.31% (24/26) and 95.12% (39/41), while the negative predictive values were 74.19% (46/62), 72.13% (44/61), 48.89% (44/90) and 57.89% (44/76). The accordance rate were 86.32% (101/117), 83.76% (98/117), 58.62% (68/116) and 70.94% (83/117), and the Youden index were 0.77,0.72, 0.30 and 0.51. The performance of the first two groups was higher than that of the last two groups. The RPM values of Mycobacterium tuberculosis detected by mNGS and tNGS were 0.22 (0.02,1.95) and 28.54 (1.65,138.16), respectively, with statistically significant difference (Z=6.338,P<0.05). The accordance rate of detection of resistance to rifampicin, fluoroquinolone, and isoniazid between tNGS and phenotypic method was 100.00%. Conclusion: mNGS and tNGS have better diagnostic efficacy in the diagnosis of pulmonary tuberculosis compared to traditional detection methods. At the same time, tNGS can also be used for drug resistance detection, providing reference for clinical treatment.

Key words: Tuberculosis,pulmonary, Alveolar lavage fluid, Molecular diagnostic techniques, Diagnosis, differentiate

CLC Number:

R521
R49

Shi Yuru, Gu Dejian, Wu Jing, Liu Ting, Qin Linghan, Yue Li, Qi Yingjie. Diagnostic value of probe capture-based targeted next-generation sequencing and metagenomic next-generation sequencing for detecting Mycobacterium tuberculosis in bronchoalveolar lavage fluid[J]. Chinese Journal of Antituberculosis, 2025, 47(3): 305-311. doi: 10.19982/j.issn.1000-6621.20240448

Figures/Tables 2

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药物/靶向捕获测序耐药基因	突变基因及位点	药敏耐药	药敏敏感	Xpert耐药	Xpert敏感
利福平
阳性	rpoB c.508G>T	1	0	0	0
阴性	-	0	22	0	30
异烟肼
阳性	katG c.944G>C	1	0
阴性	-	0	22
乙胺丁醇
阳性	-	0	0
阴性	-	0	23
链霉素
阳性	rpsL c.128A>G	1	0
阴性	-	1	21
氟喹诺酮类
阳性	gyrA c.269C>T	1	0
阴性	-	1	21