Value analysis of next-generation sequencing combined with Xpert in early precise diagnosis of pulmonary tuberculosis

Diagn Microbiol Infect Dis. 2023 Sep;107(1):115921. doi: 10.1016/j.diagmicrobio.2023.115921. Epub 2023 Feb 15.

Abstract

The current study aims to investigate the value of combination of NGS with Xpert MTB/RIF in the diagnosis of early pulmonary tuberculosis (PTB). A total of 85 patients with suspected PTB were analyzed retrospectively. The positive detection rates of PTB by Xpert MTB/RIF, TBseq Ultra, TB-DNA, and TB-RNA were significantly higher than those by acid-fast staining. Xpert MTB/RIF, TBseq Ultra, TB-DNA, and TB-RNA possessed higher sensitivity and accuracy than acid-fast stained smears. Kappa agreement analysis showed good agreement between Xpert MTB/RIF and TBseq Ultra. Combined diagnosis improves the detection sensitivity compared with a single diagnostic method. ROC curve analysis showed that Xpert MTB/RIF combined with TBseq Ultra showed the highest area under the curve (0.886). In conclusion, the combined diagnosis of TBseq Ultra and Xpert MTB/RIF harbors the characteristics of short cycle, high specificity and accuracy, which demonstrated a promising application value in the early diagnosis of PTB.

Keywords: Next-generation sequencing; Pulmonary tuberculosis; ROC curve; Tuberculosis DNA; Tuberculosis RNA; Xpert MTB/RIF.

MeSH terms

  • Antibiotics, Antitubercular*
  • Early Diagnosis
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Molecular Diagnostic Techniques / methods
  • Mycobacterium tuberculosis* / genetics
  • Retrospective Studies
  • Rifampin
  • Sensitivity and Specificity
  • Sputum
  • Tuberculosis, Pulmonary* / diagnosis

Substances

  • Rifampin
  • Antibiotics, Antitubercular