Kambli Priti, Ajbani Kanchan, Andrews Amala A, Basu Shaoli, Shetty Anjali, Patil Tanvi, Mehta Ishita, Singh Harpreet, Rodrigues Camilla
Microbiology Section, Department of Laboratory Medicine, P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, India.
Department of Microbiology, Government Medical College, Thiruvananthapuram, Kerala, India.
Indian J Med Microbiol. 2024 Sep-Oct;51:100665. doi: 10.1016/j.ijmmb.2024.100665. Epub 2024 Jul 11.
Tuberculous meningitis (TBM) is the most severe form of tuberculosis (TB). Difficulty in diagnosing the condition along with other factors, increases its potential for high morbidity and mortality. Targeted Next Generation Sequencing (tNGS) generates high quality sequence read depths, enabling the identification of low-frequency alleles linked to Drug resistance (DR). The paucibacillary nature of tuberculous meningitis is a challenge for making a definitive diagnosis.
tNGS was performed on 20 cerebrospinal fluid (CSF) samples where, MGIT has shown Positive MTB Cultures. We simultaneously performed pyrosequencing (PSQ) and phenotypic Drug susceptibility testing (pDST) for these 20 samples.
Sequencing results (from tNGS and PSQ) were compared with reference standards i.e. pDST. tNGS detected MTB in 7/20 (35%) CSF samples whereas, PSQ detected MTB in 17/20 (85%).
Although tNGS has ability to detect minority variants along with detection of additional targets than PSQ, PSQ remains the diagnostic choice in our tertiary lab.
结核性脑膜炎（TBM）是结核病（TB）最严重的形式。该病症诊断困难以及其他因素增加了其高发病率和死亡率的可能性。靶向新一代测序（tNGS）可生成高质量的序列读取深度，有助于识别与耐药性（DR）相关的低频等位基因。结核性脑膜炎的少菌特性对明确诊断构成挑战。
对20份脑脊液（CSF）样本进行tNGS检测，这些样本的MGIT显示结核分枝杆菌培养呈阳性。我们同时对这20份样本进行焦磷酸测序（PSQ）和表型药物敏感性测试（pDST）。
将测序结果（来自tNGS和PSQ）与参考标准即pDST进行比较。tNGS在7/20（35%）的脑脊液样本中检测到结核分枝杆菌，而PSQ在17/20（85%）的样本中检测到结核分枝杆菌。
尽管tNGS能够检测少数变异体，且比PSQ能检测更多靶点，但在我们的三级实验室中，PSQ仍是诊断选择。
