%0 Journal Article
%T Exploring the accuracy of third-generation Nanopore Sequencing technology for detecting mycobacterium tuberculosis in patients with diabetes mellitus.
%A Song C
%A Zhao C
%A Nong Y
%A Lin Y
%A Huang A
%A Xi S
%A Wei X
%A Zeng C
%A Qin Y
%A Zhu Q
%J Diagn Microbiol Infect Dis
%V 110
%N 1
%D 2024 Jun 6
%M 38875895
%F 2.983
%R 10.1016/j.diagmicrobio.2024.116392
%X <B>OBJECTIVE: </B>To explore the diagnostic value of third-generation nanopore sequencing technology in patients with diabetes mellitus suspected of pulmonary tuberculosis.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.