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Abstract：
OBJECTIVE: This study aimed to evaluate the efficiency of nanopore sequencing for the early diagnosis of tuberculous meningitis (TBM) using cerebrospinal fluid and compared it with acid-fast bacilli (AFB) smear, mycobacterial growth indicator tube culture and Xpert Mycobacterium tuberculosis (MTB)/rifampicin (RIF).
METHODS: Single-centre retrospective study.
METHODS: The Tuberculosis Diagnosis and Treatment Center of Zhejiang Chinese and Western Medicine Integrated Hospital.
METHODS: We enrolled 64 adult patients with presumptive TBM admitted to our hospital from August 2021 to August 2023.
METHODS: We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of AFB smear, culture, Xpert MTB/RIF and nanopore sequencing to evaluate their diagnostic efficacy compared with a composite reference standard for TBM.
RESULTS: Among these 64 patients, all tested negative for TBM by AFB smear. The sensitivity, specificity, PPV and NPV were 11.11%, 100%, 100% and 32.2% for culture, 13.33%, 100%, 100% and 2.76% for Xpert MTB/RIF, and 77.78%, 100%, 100% and 65.52% for nanopore sequencing, respectively.
CONCLUSIONS: The diagnostic accuracy of the nanopore sequencing test was significantly higher than that of conventional testing methods used to detect TBM.
METHODS: Single-centre retrospective study.
METHODS: The Tuberculosis Diagnosis and Treatment Center of Zhejiang Chinese and Western Medicine Integrated Hospital.
METHODS: We enrolled 64 adult patients with presumptive TBM admitted to our hospital from August 2021 to August 2023.
METHODS: We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of AFB smear, culture, Xpert MTB/RIF and nanopore sequencing to evaluate their diagnostic efficacy compared with a composite reference standard for TBM.
RESULTS: Among these 64 patients, all tested negative for TBM by AFB smear. The sensitivity, specificity, PPV and NPV were 11.11%, 100%, 100% and 32.2% for culture, 13.33%, 100%, 100% and 2.76% for Xpert MTB/RIF, and 77.78%, 100%, 100% and 65.52% for nanopore sequencing, respectively.
CONCLUSIONS: The diagnostic accuracy of the nanopore sequencing test was significantly higher than that of conventional testing methods used to detect TBM.
摘要：
目的：本研究旨在评估纳米孔测序对脑脊液早期诊断结核性脑膜炎（TBM）的效率，并将其与抗酸杆菌（AFB）涂片进行比较。分枝杆菌生长指示管培养和Xpert结核分枝杆菌（MTB）/利福平（RIF）。
方法：单中心回顾性研究。
方法：浙江省中西医结合医院结核病诊疗中心.
方法：我们招募了2021年8月至2023年8月我院收治的64名成人TBM患者。
方法：我们计算了灵敏度，特异性，AFB涂片的阳性预测值（PPV）和阴性预测值（NPV），文化,与TBM的复合参考标准相比，XpertMTB/RIF和纳米孔测序以评估其诊断功效。
结果：在这64名患者中，AFB涂片检查结果均为TBM阴性。敏感性,特异性，PPV和NPV为11.11%，100%,100%和32.2%的文化，13.33%,100%,XpertMTB/RIF的100%和2.76%，77.78%，100%,100%和65.52%的纳米孔测序，分别。
结论：纳米孔测序测试的诊断准确性明显高于用于检测TBM的常规测试方法。
方法：单中心回顾性研究。
方法：浙江省中西医结合医院结核病诊疗中心.
方法：我们招募了2021年8月至2023年8月我院收治的64名成人TBM患者。
方法：我们计算了灵敏度，特异性，AFB涂片的阳性预测值（PPV）和阴性预测值（NPV），文化,与TBM的复合参考标准相比，XpertMTB/RIF和纳米孔测序以评估其诊断功效。
结果：在这64名患者中，AFB涂片检查结果均为TBM阴性。敏感性,特异性，PPV和NPV为11.11%，100%,100%和32.2%的文化，13.33%,100%,XpertMTB/RIF的100%和2.76%，77.78%，100%,100%和65.52%的纳米孔测序，分别。
结论：纳米孔测序测试的诊断准确性明显高于用于检测TBM的常规测试方法。
