Department of Tuberculosis, The Fourth People's Hospital of Nanning, NO.1 Changgang-two-li Road, Nanning, Guangxi, China, 530023; Guangxi Medical University, Nanning, China.
Department of Medical, The Fourth People's Hospital of Nanning, NO.1 Changgang-two-li Road, Nanning, Guangxi, China, 530023.
Diagn Microbiol Infect Dis. 2024 Sep;110(1):116392. doi: 10.1016/j.diagmicrobio.2024.116392. Epub 2024 Jun 6.
To explore the diagnostic value of third-generation nanopore sequencing technology in patients with diabetes mellitus suspected of pulmonary tuberculosis.
Samples, including sputum and bronchoalveolar lavage fluid(BALF), were collected from patients with diabetes mellitus suspected of pulmonary tuberculosis who were admitted from October 2021 to August 2023. Nanopore sequencing, acid-fast bacilli (AFB) smear, mycobacterial solid culture, Xpert MTB/RIF, and DNA detection were performed, and their diagnostic efficacy was compared.
Third-generation nanopore sequencing technology exhibited high accuracy in diagnosing pulmonary tuberculosis in patients with diabetes mellitus. Compared to traditional methods, nanopore sequencing showed significantly improved sensitivity (76.80 %), negative predictive value (30.40 %), coincidence (77.92 %), and diagnostic accuracy (AUC = 0.822). Combined detection with Xpert achieved the highest diagnostic performance, with increased sensitivity (81.20 %), positive predictive value (98.20 %), negative predictive value (35.00 %), coincidence (81.82 %), and AUC (0.843). Although acid-fast staining had limitations, its combination with nanopore sequencing improved screening effectiveness.
Compared to established diagnostic modalities such as acid-fast staining, mycobacterial solid culture, Xpert MTB/RIF, and DNA detection, third-generation nanopore sequencing technology demonstrates a significant improvement in sensitivity for detecting suspected pulmonary tuberculosis in diabetic patients. Notably, the combined application of nanopore sequencing with Xpert testing offers a further enhancement in diagnostic accuracy.
探讨第三代纳米孔测序技术在疑似糖尿病合并肺结核患者中的诊断价值。
收集 2021 年 10 月至 2023 年 8 月疑似糖尿病合并肺结核患者的痰液和支气管肺泡灌洗液（BALF）标本，分别进行纳米孔测序、抗酸染色、分枝杆菌固体培养、Xpert MTB/RIF、DNA 检测，比较其诊断效能。
第三代纳米孔测序技术对糖尿病合并肺结核患者的诊断准确性较高，与传统方法相比，纳米孔测序的灵敏度（76.80%）、阴性预测值（30.40%）、符合率（77.92%）、诊断准确率（AUC=0.822）均显著提高，与 Xpert 联合检测的诊断效能最高，灵敏度（81.20%）、阳性预测值（98.20%）、阴性预测值（35.00%）、符合率（81.82%）、AUC（0.843）均升高，虽然抗酸染色有局限性，但与纳米孔测序联合可提高筛查效果。
与抗酸染色、分枝杆菌固体培养、Xpert MTB/RIF、DNA 检测等传统诊断方法相比，第三代纳米孔测序技术对疑似糖尿病合并肺结核患者的检测灵敏度显著提高，纳米孔测序与 Xpert 联合应用可进一步提高诊断准确性。
