Application of Metagenomic and Targeted Next-Generation Sequencing in Diagnosis of Pulmonary Tuberculosis in Bronchoalveolar Lavage Fluid

Zhen Yang,* Qian Liu,* Yi Hu, Shuang Geng, Ji-Xiang Ni Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China*These author...

Full description

Saved in:
Bibliographic Details
Main Authors: Yang Z, Liu Q, Hu Y, Geng S, Ni JX
Format: Article
Language:English
Published: Dove Medical Press 2025-05-01
Series:Infection and Drug Resistance
Subjects:
Online Access:https://www.dovepress.com/application-of-metagenomic-and-targeted-next-generation-sequencing-in--peer-reviewed-fulltext-article-IDR
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850189860457938944
author Yang Z
Liu Q
Hu Y
Geng S
Ni JX
author_facet Yang Z
Liu Q
Hu Y
Geng S
Ni JX
author_sort Yang Z
collection DOAJ
description Zhen Yang,* Qian Liu,* Yi Hu, Shuang Geng, Ji-Xiang Ni Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shuang Geng, Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26 Shengli Street, Jiangan District, Wuhan, Hubei, 430014, People’s Republic of China, Tel +86-13476192468, Email gengshuangsky@163.com Ji-Xiang Ni, Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26 Shengli Street, Jiangan District, Wuhan, Hubei, 430014, People’s Republic of China, Email Neejx77@163.comPurpose: To explore the application value of metagenomic next-generation sequencing (mNGS) and targeted next-generation sequencing (tNGS) in the diagnosis of pulmonary tuberculosis (PTB) in bronchoalveolar lavage fluid (BALF).Patients and Methods: Data from 202 patients with suspected PTB at Wuhan Central Hospital (Jan 2022 - Jan 2024) were retrospectively analyzed. BALF samples were collected and examined using mNGS and tNGS, comparing their sensitivity to traditional methods like acid-fast staining, TB culture, and TB-DNA. Mixed microbial species were identified from the BALF using mNGS and tNGS, and the pros and cons of tNGS were evaluated against mNGS.Results: Of the 202 patients evaluated, 94 were diagnosed with PTB. The BALF mNGS and tNGS exhibited a sensitivity of 77.66% and a specificity of 100%, with positive and negative predictive values of 100% and 83.72%, respectively, outperforming conventional diagnostic methods. It was possible to compare the AUC values of the ROC curves of the BALF mNGS and tNGS with the corresponding values of the other three assay methods (0.89 vs 0.56, p < 0.05), MTB culture (0.89 vs 0.71, p < 0.05), and TB-DNA (0.89 vs 0.68, p < 0.05). Additionally, these techniques identified mixed microbial species in 52.13% of the BALF samples. Although both mNGS and tNGS demonstrated similar diagnostic rates, tNGS proved to be faster, more cost-effective, and incorporated a tuberculosis-specific wall-breaking technology, thereby suggesting greater clinical utility.Conclusion: BALF mNGS and tNGS technologies quickly and accurately detect PTB patients with greater sensitivity and specificity than traditional MTB methods. While both mNGS and tNGS demonstrate enhanced capacity for polymicrobial detection, the clinical significance of co-detected microorganisms requires integration with clinical context to differentiate colonization from active infection. Compared to mNGS, tNGS provides distinct advantages in clinical utility.Keywords: metagenomic next-generation sequencing, targeted next-generation sequencing, pulmonary tuberculosis, bronchoalveolar lavage fluid, diagnosis
format Article
id doaj-art-196cb33d852847b496fbd83d3eac8fbb
institution OA Journals
issn 1178-6973
language English
publishDate 2025-05-01
publisher Dove Medical Press
record_format Article
series Infection and Drug Resistance
spelling doaj-art-196cb33d852847b496fbd83d3eac8fbb2025-08-20T02:15:29ZengDove Medical PressInfection and Drug Resistance1178-69732025-05-01Volume 18Issue 122292241102649Application of Metagenomic and Targeted Next-Generation Sequencing in Diagnosis of Pulmonary Tuberculosis in Bronchoalveolar Lavage FluidYang Z0Liu Q1Hu Y2Geng S3Ni JX4Department of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineDepartment of Respiratory and Critical Care MedicineZhen Yang,* Qian Liu,* Yi Hu, Shuang Geng, Ji-Xiang Ni Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shuang Geng, Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26 Shengli Street, Jiangan District, Wuhan, Hubei, 430014, People’s Republic of China, Tel +86-13476192468, Email gengshuangsky@163.com Ji-Xiang Ni, Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26 Shengli Street, Jiangan District, Wuhan, Hubei, 430014, People’s Republic of China, Email Neejx77@163.comPurpose: To explore the application value of metagenomic next-generation sequencing (mNGS) and targeted next-generation sequencing (tNGS) in the diagnosis of pulmonary tuberculosis (PTB) in bronchoalveolar lavage fluid (BALF).Patients and Methods: Data from 202 patients with suspected PTB at Wuhan Central Hospital (Jan 2022 - Jan 2024) were retrospectively analyzed. BALF samples were collected and examined using mNGS and tNGS, comparing their sensitivity to traditional methods like acid-fast staining, TB culture, and TB-DNA. Mixed microbial species were identified from the BALF using mNGS and tNGS, and the pros and cons of tNGS were evaluated against mNGS.Results: Of the 202 patients evaluated, 94 were diagnosed with PTB. The BALF mNGS and tNGS exhibited a sensitivity of 77.66% and a specificity of 100%, with positive and negative predictive values of 100% and 83.72%, respectively, outperforming conventional diagnostic methods. It was possible to compare the AUC values of the ROC curves of the BALF mNGS and tNGS with the corresponding values of the other three assay methods (0.89 vs 0.56, p < 0.05), MTB culture (0.89 vs 0.71, p < 0.05), and TB-DNA (0.89 vs 0.68, p < 0.05). Additionally, these techniques identified mixed microbial species in 52.13% of the BALF samples. Although both mNGS and tNGS demonstrated similar diagnostic rates, tNGS proved to be faster, more cost-effective, and incorporated a tuberculosis-specific wall-breaking technology, thereby suggesting greater clinical utility.Conclusion: BALF mNGS and tNGS technologies quickly and accurately detect PTB patients with greater sensitivity and specificity than traditional MTB methods. While both mNGS and tNGS demonstrate enhanced capacity for polymicrobial detection, the clinical significance of co-detected microorganisms requires integration with clinical context to differentiate colonization from active infection. Compared to mNGS, tNGS provides distinct advantages in clinical utility.Keywords: metagenomic next-generation sequencing, targeted next-generation sequencing, pulmonary tuberculosis, bronchoalveolar lavage fluid, diagnosishttps://www.dovepress.com/application-of-metagenomic-and-targeted-next-generation-sequencing-in--peer-reviewed-fulltext-article-IDRmetagenomic next-generation sequencingtargeted next-generation sequencingpulmonary tuberculosisbronchoalveolar lavage fluiddiagnosis
spellingShingle Yang Z
Liu Q
Hu Y
Geng S
Ni JX
Application of Metagenomic and Targeted Next-Generation Sequencing in Diagnosis of Pulmonary Tuberculosis in Bronchoalveolar Lavage Fluid
Infection and Drug Resistance
metagenomic next-generation sequencing
targeted next-generation sequencing
pulmonary tuberculosis
bronchoalveolar lavage fluid
diagnosis
title Application of Metagenomic and Targeted Next-Generation Sequencing in Diagnosis of Pulmonary Tuberculosis in Bronchoalveolar Lavage Fluid
title_full Application of Metagenomic and Targeted Next-Generation Sequencing in Diagnosis of Pulmonary Tuberculosis in Bronchoalveolar Lavage Fluid
title_fullStr Application of Metagenomic and Targeted Next-Generation Sequencing in Diagnosis of Pulmonary Tuberculosis in Bronchoalveolar Lavage Fluid
title_full_unstemmed Application of Metagenomic and Targeted Next-Generation Sequencing in Diagnosis of Pulmonary Tuberculosis in Bronchoalveolar Lavage Fluid
title_short Application of Metagenomic and Targeted Next-Generation Sequencing in Diagnosis of Pulmonary Tuberculosis in Bronchoalveolar Lavage Fluid
title_sort application of metagenomic and targeted next generation sequencing in diagnosis of pulmonary tuberculosis in bronchoalveolar lavage fluid
topic metagenomic next-generation sequencing
targeted next-generation sequencing
pulmonary tuberculosis
bronchoalveolar lavage fluid
diagnosis
url https://www.dovepress.com/application-of-metagenomic-and-targeted-next-generation-sequencing-in--peer-reviewed-fulltext-article-IDR
work_keys_str_mv AT yangz applicationofmetagenomicandtargetednextgenerationsequencingindiagnosisofpulmonarytuberculosisinbronchoalveolarlavagefluid
AT liuq applicationofmetagenomicandtargetednextgenerationsequencingindiagnosisofpulmonarytuberculosisinbronchoalveolarlavagefluid
AT huy applicationofmetagenomicandtargetednextgenerationsequencingindiagnosisofpulmonarytuberculosisinbronchoalveolarlavagefluid
AT gengs applicationofmetagenomicandtargetednextgenerationsequencingindiagnosisofpulmonarytuberculosisinbronchoalveolarlavagefluid
AT nijx applicationofmetagenomicandtargetednextgenerationsequencingindiagnosisofpulmonarytuberculosisinbronchoalveolarlavagefluid