Nanopore-based targeted sequencing (NTS) for drug-resistant tuberculosis: an integrated tool for personalized treatment strategies and guidance for new drug development
Abstract Background Drug-resistant tuberculosis has emerged as a major public health issue that requires immediate attention. NTS is an innovative method that allows for the direct detection of clinical samples without the need for culture. It could provide more accurate, reliable, and comprehensive...
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BMC
2025-07-01
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| Online Access: | https://doi.org/10.1186/s12879-025-11227-4 |
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| author | Chen Yang Guangchuan Dai Yicheng Guo Tianzhen Wang Weiwei Gao Yi Zeng |
| author_facet | Chen Yang Guangchuan Dai Yicheng Guo Tianzhen Wang Weiwei Gao Yi Zeng |
| author_sort | Chen Yang |
| collection | DOAJ |
| description | Abstract Background Drug-resistant tuberculosis has emerged as a major public health issue that requires immediate attention. NTS is an innovative method that allows for the direct detection of clinical samples without the need for culture. It could provide more accurate, reliable, and comprehensive information on drug resistance. Methods We collected clinical data retrospectively from patients suspected of having drug-resistant tuberculosis who visited the tuberculosis department at the Second Hospital of Nanjing in Jiangsu Province, China, from December 2023 to December 2024. The diagnostic efficiency of NTS for different types of drug-resistant tuberculosis and antimicrobial resistance was calculated. The relationship between resistance genes, mutated amino acids, and mutation sites was demonstrated. Results In this study, a total of 107 patients with drug-resistant tuberculosis were included, comprising 43 cases of mono-drug resistant tuberculosis, 20 patients with poly-drug resistant tuberculosis, 22 cases of multidrug-resistant tuberculosis, 21 cases of pre-extensively drug-resistant tuberculosis and 1 case of extensively drug-resistant tuberculosis. The accuracy of NTS in diagnosing drug-resistant tuberculosis ranged from 42.9 to 93.0%. Except for second-line injectable drugs, NTS achieved a sensitivity of over 70% for other anti-tuberculosis drugs. Serine was identified as the most frequently mutated amino acid in both the rpoB gene (66.2%, 49/74) and the katG gene (86.3%, 44/51). Additionally, the most frequently mutated amino acids in the embB gene, rpsL gene, and gyrA gene were methionine (94.7%, 44/51), lysine (100%, 28/28), and aspartic acid (66.7%, 20/30), respectively. Conclusion NTS could effectively and precisely deliver comprehensive drug resistance results, assisting medical professionals to create more personalized treatment plans. Besides, it would encourage the development of new anti-tuberculosis drugs to broaden clinical treatment options for drug-resistant tuberculosis. |
| format | Article |
| id | doaj-art-67a31b8de7d44fbb9a965ebe8d0b9e96 |
| institution | DOAJ |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-67a31b8de7d44fbb9a965ebe8d0b9e962025-08-20T03:03:24ZengBMCBMC Infectious Diseases1471-23342025-07-0125111410.1186/s12879-025-11227-4Nanopore-based targeted sequencing (NTS) for drug-resistant tuberculosis: an integrated tool for personalized treatment strategies and guidance for new drug developmentChen Yang0Guangchuan Dai1Yicheng Guo2Tianzhen Wang3Weiwei Gao4Yi Zeng5Department of Tuberculosis, The Second Hospital of NanjingDepartment of Tuberculosis, The Second Hospital of NanjingDepartment of Tuberculosis, The Second Hospital of Nanjing, The School of Public Health of Nanjing Medical UniversityDepartment of Tuberculosis, The Second Hospital of NanjingDepartment of Tuberculosis, The Second Hospital of NanjingDepartment of Tuberculosis, The Second Hospital of NanjingAbstract Background Drug-resistant tuberculosis has emerged as a major public health issue that requires immediate attention. NTS is an innovative method that allows for the direct detection of clinical samples without the need for culture. It could provide more accurate, reliable, and comprehensive information on drug resistance. Methods We collected clinical data retrospectively from patients suspected of having drug-resistant tuberculosis who visited the tuberculosis department at the Second Hospital of Nanjing in Jiangsu Province, China, from December 2023 to December 2024. The diagnostic efficiency of NTS for different types of drug-resistant tuberculosis and antimicrobial resistance was calculated. The relationship between resistance genes, mutated amino acids, and mutation sites was demonstrated. Results In this study, a total of 107 patients with drug-resistant tuberculosis were included, comprising 43 cases of mono-drug resistant tuberculosis, 20 patients with poly-drug resistant tuberculosis, 22 cases of multidrug-resistant tuberculosis, 21 cases of pre-extensively drug-resistant tuberculosis and 1 case of extensively drug-resistant tuberculosis. The accuracy of NTS in diagnosing drug-resistant tuberculosis ranged from 42.9 to 93.0%. Except for second-line injectable drugs, NTS achieved a sensitivity of over 70% for other anti-tuberculosis drugs. Serine was identified as the most frequently mutated amino acid in both the rpoB gene (66.2%, 49/74) and the katG gene (86.3%, 44/51). Additionally, the most frequently mutated amino acids in the embB gene, rpsL gene, and gyrA gene were methionine (94.7%, 44/51), lysine (100%, 28/28), and aspartic acid (66.7%, 20/30), respectively. Conclusion NTS could effectively and precisely deliver comprehensive drug resistance results, assisting medical professionals to create more personalized treatment plans. Besides, it would encourage the development of new anti-tuberculosis drugs to broaden clinical treatment options for drug-resistant tuberculosis.https://doi.org/10.1186/s12879-025-11227-4Drug-resistant tuberculosis(DR-TB)Drug-resistant genesNanopore-based targeted sequencing(NTS)Targeted next-generation sequencing(tNGS)Amino acids |
| spellingShingle | Chen Yang Guangchuan Dai Yicheng Guo Tianzhen Wang Weiwei Gao Yi Zeng Nanopore-based targeted sequencing (NTS) for drug-resistant tuberculosis: an integrated tool for personalized treatment strategies and guidance for new drug development BMC Infectious Diseases Drug-resistant tuberculosis(DR-TB) Drug-resistant genes Nanopore-based targeted sequencing(NTS) Targeted next-generation sequencing(tNGS) Amino acids |
| title | Nanopore-based targeted sequencing (NTS) for drug-resistant tuberculosis: an integrated tool for personalized treatment strategies and guidance for new drug development |
| title_full | Nanopore-based targeted sequencing (NTS) for drug-resistant tuberculosis: an integrated tool for personalized treatment strategies and guidance for new drug development |
| title_fullStr | Nanopore-based targeted sequencing (NTS) for drug-resistant tuberculosis: an integrated tool for personalized treatment strategies and guidance for new drug development |
| title_full_unstemmed | Nanopore-based targeted sequencing (NTS) for drug-resistant tuberculosis: an integrated tool for personalized treatment strategies and guidance for new drug development |
| title_short | Nanopore-based targeted sequencing (NTS) for drug-resistant tuberculosis: an integrated tool for personalized treatment strategies and guidance for new drug development |
| title_sort | nanopore based targeted sequencing nts for drug resistant tuberculosis an integrated tool for personalized treatment strategies and guidance for new drug development |
| topic | Drug-resistant tuberculosis(DR-TB) Drug-resistant genes Nanopore-based targeted sequencing(NTS) Targeted next-generation sequencing(tNGS) Amino acids |
| url | https://doi.org/10.1186/s12879-025-11227-4 |
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