Abstract:

Objective: To explore the diagnostic value of metagenomic next-generation sequencing (mNGS) in patients with suspected osteoarticular tuberculosis. Methods: Retrospective analysis was conducted on data of 176 suspected osteoarticular tuberculosis patients (including 57 patients with osteoarticular tuberculosis and 119 patients with non-tuberculous osteoarticular disease) admitted to Beijing Chest Hospital, Capital Medical University from January 2019 to January 2023. Samples of all subjects were simultaneously subjected to BACTEC MGIT 960 liquid culture (referred to as “MGIT 960 culture”), GeneXpert MTB/RIF detection (referred to as “Xpert” detection) and mNGS detection, then positive predictive value, negative predictive value, sensitivity and specificity of those three methods were analyzed. Results: Results of mNGS detection showed that 80 cases (45.5%) were infected with purulent bacteria, 73 cases (41.5%) with mycobacteria, 22 cases (12.5%) with fungi, and 1 case (0.6%) with actinomyces. Among the 73 mycobacteria cases, 57 (32.4%) were Mycobacterium tuberculosis. The positive predictive values of mNGS, Xpert and MGIT 960 culture were 87.7% (95%CI: 77.6%-93.7%), 100.0% (95%CI: 93.5%-100.0%), 100.0% (95%CI: 89.4%-100.0%), respectively, while their negative predictive values were 94.1% (95%CI: 88.9%-97.0%), 98.3% (95%CI: 93.8%-99.6%) and 83.2%(95%CI:78.5%-87.1%), respectively. The sensitivities of mNGS and Xpert were 87.7% (95%CI: 76.3%-94.9%) and 96.5% (95%CI: 87.9%-99.6%), respectively, higher than those of MGIT 960 culture (57.9%, 95%CI: 44.1%-70.9%). The specificities of mNGS, Xpert and MGIT 960 cultures were 94.1% (95%CI: 88.3%-97.6%), 100.0% (95%CI: 96.9%-100.0%) and 100.0% (95%CI: 96.9%-100.0%), respectively. Conclusion: mNGS has a high diagnostic value in patients with suspected osteoarticular tuberculosis.

Key words: Tuberculosis,osteoarticular, Molecular diagnostic techniques, Evaluation studies