Diagnostic Value of Targeted Next-generation Sequencing in Pulmonary Mycobacterial Infections.

IF 2 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Current Medical Science Pub Date : 2024-10-01 Epub Date: 2024-10-05 DOI:10.1007/s11596-024-2937-4

Yu Tao, Zi-Wei Zhou, Yi-Fei Duan, Jian-Miao Wang

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Abstract

Objective: This study aimed to explore the diagnostic value of novel technique-targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid (BALF) in pulmonary mycobacterial infections.

Methods: This retrospective study was conducted on patients who underwent bronchoscopy and tNGS, smear microscopy, and mycobacterial culture of BALF. Patients with positive Mycobacterium tuberculosis (MTB) culture or GeneXpert results were classified into the tuberculosis case group. Those diagnosed with nontuberculous mycobacteria (NTM)-pulmonary disease (NTM-PD) composed the case group of NTM-PD patients. The control group comprised patients without tuberculosis or NTM-PD. Sensitivity, specificity, and receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance.

Results: For tuberculosis patients with positive mycobacterial culture results, the areas under the ROC curves (AUCs) for tNGS, GeneXpert, and smear microscopy were 0.975 (95% CI: 0.935, 1.000), 0.925 (95% CI: 0.859, 0.991), and 0.675 (95% CI: 0.563, 0.787), respectively. For tuberculosis patients with positive GeneXpert results, the AUCs of tNGS, culture, and smear microscopy were 0.970 (95% CI: 0.931, 1.000), 0.850 (95% CI: 0.770, 0.930), and 0.680 (95% CI: 0.579, 0.781), respectively. For NTM-PD, the AUCs of tNGS, culture, and smear-positive but GeneXpert-negative results were 0.987 (95% CI: 0.967, 1.000), 0.750 (95% CI: 0.622, 0.878), and 0.615 (95% CI: 0.479, 0.752), respectively. The sensitivity and specificity of tNGS in NTM-PD patients were 100% and 97.5%, respectively.

Conclusion: tNGS demonstrated superior diagnostic efficacy in mycobacterial infection, indicating its potential for clinical application.

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肺分枝杆菌感染中靶向新一代测序的诊断价值。

研究目的本研究旨在探讨支气管肺泡灌洗液（BALF）的新型靶向新一代测序技术（tNGS）在肺分枝杆菌感染中的诊断价值：这项回顾性研究的对象是接受支气管镜检查和 tNGS、涂片镜检以及 BALF 分枝杆菌培养的患者。结核分枝杆菌（MTB）培养或 GeneXpert 结果呈阳性的患者被归入结核病例组。被确诊为非结核分枝杆菌（NTM）-肺部疾病（NTM-PD）的患者组成非结核分枝杆菌-肺部疾病病例组。对照组由没有结核病或非结核分枝杆菌肺病的患者组成。灵敏度、特异性和接收器操作特征曲线（ROC）用于评估诊断效果：对于分枝杆菌培养结果呈阳性的肺结核患者，tNGS、GeneXpert 和涂片镜检的 ROC 曲线下面积（AUC）分别为 0.975（95% CI：0.935，1.000）、0.925（95% CI：0.859，0.991）和 0.675（95% CI：0.563，0.787）。对于 GeneXpert 结果呈阳性的结核病患者，tNGS、培养和涂片镜检的 AUC 分别为 0.970（95% CI：0.931，1.000）、0.850（95% CI：0.770，0.930）和 0.680（95% CI：0.579，0.781）。对于 NTM-PD，tNGS、培养和涂片阳性但 GeneXpert 阴性结果的 AUC 分别为 0.987（95% CI：0.967，1.000）、0.750（95% CI：0.622，0.878）和 0.615（95% CI：0.479，0.752）。在 NTM-PD 患者中，tNGS 的敏感性和特异性分别为 100% 和 97.5%。

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来源期刊

Current Medical Science Biochemistry, Genetics and Molecular Biology-Genetics

CiteScore

4.70

自引率

0.00%

发文量

126

期刊介绍： Current Medical Science provides a forum for peer-reviewed papers in the medical sciences, to promote academic exchange between Chinese researchers and doctors and their foreign counterparts. The journal covers the subjects of biomedicine such as physiology, biochemistry, molecular biology, pharmacology, pathology and pathophysiology, etc., and clinical research, such as surgery, internal medicine, obstetrics and gynecology, pediatrics and otorhinolaryngology etc. The articles appearing in Current Medical Science are mainly in English, with a very small number of its papers in German, to pay tribute to its German founder. This journal is the only medical periodical in Western languages sponsored by an educational institution located in the central part of China.