Diagnostic value of third-generation nanopore sequencing in extrapulmonary tuberculosis

Area of Science:

• Microbiology
• Genomic Sequencing
• Infectious Disease Diagnostics

Background:

• Extrapulmonary tuberculosis (EPTB) diagnosis remains challenging.
• Accurate and rapid diagnostic tools are crucial for effective EPTB management.

Purpose of the Study:

• To evaluate the diagnostic accuracy of third-generation nanopore sequencing for EPTB.
• To compare nanopore sequencing with conventional diagnostic methods for EPTB.

Main Methods:

• Collected lesion samples from 67 suspected EPTB patients.
• Performed nanopore sequencing, AFB staining, DNA testing, X-pert, and mycobacterial cultures.
• Calculated sensitivity, specificity, PPV, NPV, and AUC for each method.

Main Results:

• Nanopore sequencing achieved the highest correct diagnosis rate in 50 positive EPTB cases.
• It identified 19 cases missed by conventional diagnostics.
• Demonstrated superior sensitivity (62.00%), specificity (94.10%), PPV (96.90%), and AUC (0.781) compared to other methods.

Conclusions:

• Nanopore sequencing significantly outperforms AFB staining, DNA testing, X-pert, and mycobacterial culture for EPTB diagnosis.
• This technology holds promise for improving EPTB detection rates and patient outcomes.