Combining interferon-γ release assays and metagenomic next-generation sequencing for diagnosis of pulmonary tuberculosis: a retrospective study

Abstract Background Rapid diagnosis of pulmonary tuberculosis (PTB) is urgently needed. We aimed to improve diagnosis rates by combining tuberculosis-interferon (IFN)-γ release assays (TB-IGRA) with metagenomic next-generation sequencing (mNGS) for PTB diagnosis. Methods A retrospective study of 29...

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Main Authors: Yanyan Liu, Miaohong Fang, Chenxi Yuan, Yi Yang, Liang Yu, Yasheng Li, Lifen Hu, Jiabin Li
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-024-10206-5
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author Yanyan Liu
Miaohong Fang
Chenxi Yuan
Yi Yang
Liang Yu
Yasheng Li
Lifen Hu
Jiabin Li
author_facet Yanyan Liu
Miaohong Fang
Chenxi Yuan
Yi Yang
Liang Yu
Yasheng Li
Lifen Hu
Jiabin Li
author_sort Yanyan Liu
collection DOAJ
description Abstract Background Rapid diagnosis of pulmonary tuberculosis (PTB) is urgently needed. We aimed to improve diagnosis rates by combining tuberculosis-interferon (IFN)-γ release assays (TB-IGRA) with metagenomic next-generation sequencing (mNGS) for PTB diagnosis. Methods A retrospective study of 29 PTB and 32 non-TB patients from our hospital was conducted between October 2022 and June 2023. Samples were processed for TB-IGRA and mNGS tests according to the manufacturer’s protocol. Results The levels of IFN-γ release in PTB patients were significantly higher than those in non-TB patients (604.15 ± 112.18 pg/mL, and 1.04 ± 0.38 pg/mL, respectively; p < 0.0001). Regarding presenting symptoms or signs, cough and thoracalgia were less common in PTB patients than in non-TB patients (p = 0.001 and p = 0.024, respectively). Total protein and albumin levels in the sera of PTB patients were significantly elevated compared to non-TB patients (p = 0.039 and p = 0.004, respectively). The area under the ROC curve (AUC) for TB-IGRA in PTB diagnosis was 0.939. With an optimal IFN-γ cut-off value of 14.3 pg/mL (Youden’s index 0.831), sensitivity was 86.2% and specificity was 96.9%. ROC curve analysis for mNGS and TB-IGRA combined with mNGS showed AUCs of 0.879 and 1, respectively. The AUC of TB-IGRA combined with mNGS was higher than that of TB-IGRA and mNGS alone. Conclusions TB-IGRA combined with mNGS may be an effective method for diagnosing tuberculosis, and can be used in the clinical diagnosis of PTB.
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spelling doaj-art-ea0b2710b79340a7a9f9b5bab1ce1cc82025-08-20T02:32:49ZengBMCBMC Infectious Diseases1471-23342024-11-012411810.1186/s12879-024-10206-5Combining interferon-γ release assays and metagenomic next-generation sequencing for diagnosis of pulmonary tuberculosis: a retrospective studyYanyan Liu0Miaohong Fang1Chenxi Yuan2Yi Yang3Liang Yu4Yasheng Li5Lifen Hu6Jiabin Li7Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Infectious Diseases, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Infectious Diseases, The First Affiliated Hospital of Anhui Medical UniversityAnhui Province Key Laboratory of Infectious Diseases, Anhui Medical UniversityAnhui Province Key Laboratory of Infectious Diseases, Anhui Medical UniversityAnhui Province Key Laboratory of Infectious Diseases, Anhui Medical UniversityDepartment of Infectious Diseases, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Infectious Diseases, The First Affiliated Hospital of Anhui Medical UniversityAbstract Background Rapid diagnosis of pulmonary tuberculosis (PTB) is urgently needed. We aimed to improve diagnosis rates by combining tuberculosis-interferon (IFN)-γ release assays (TB-IGRA) with metagenomic next-generation sequencing (mNGS) for PTB diagnosis. Methods A retrospective study of 29 PTB and 32 non-TB patients from our hospital was conducted between October 2022 and June 2023. Samples were processed for TB-IGRA and mNGS tests according to the manufacturer’s protocol. Results The levels of IFN-γ release in PTB patients were significantly higher than those in non-TB patients (604.15 ± 112.18 pg/mL, and 1.04 ± 0.38 pg/mL, respectively; p < 0.0001). Regarding presenting symptoms or signs, cough and thoracalgia were less common in PTB patients than in non-TB patients (p = 0.001 and p = 0.024, respectively). Total protein and albumin levels in the sera of PTB patients were significantly elevated compared to non-TB patients (p = 0.039 and p = 0.004, respectively). The area under the ROC curve (AUC) for TB-IGRA in PTB diagnosis was 0.939. With an optimal IFN-γ cut-off value of 14.3 pg/mL (Youden’s index 0.831), sensitivity was 86.2% and specificity was 96.9%. ROC curve analysis for mNGS and TB-IGRA combined with mNGS showed AUCs of 0.879 and 1, respectively. The AUC of TB-IGRA combined with mNGS was higher than that of TB-IGRA and mNGS alone. Conclusions TB-IGRA combined with mNGS may be an effective method for diagnosing tuberculosis, and can be used in the clinical diagnosis of PTB.https://doi.org/10.1186/s12879-024-10206-5TB-IGRATuberculosismNGSIFN-γSputum smears
spellingShingle Yanyan Liu
Miaohong Fang
Chenxi Yuan
Yi Yang
Liang Yu
Yasheng Li
Lifen Hu
Jiabin Li
Combining interferon-γ release assays and metagenomic next-generation sequencing for diagnosis of pulmonary tuberculosis: a retrospective study
BMC Infectious Diseases
TB-IGRA
Tuberculosis
mNGS
IFN-γ
Sputum smears
title Combining interferon-γ release assays and metagenomic next-generation sequencing for diagnosis of pulmonary tuberculosis: a retrospective study
title_full Combining interferon-γ release assays and metagenomic next-generation sequencing for diagnosis of pulmonary tuberculosis: a retrospective study
title_fullStr Combining interferon-γ release assays and metagenomic next-generation sequencing for diagnosis of pulmonary tuberculosis: a retrospective study
title_full_unstemmed Combining interferon-γ release assays and metagenomic next-generation sequencing for diagnosis of pulmonary tuberculosis: a retrospective study
title_short Combining interferon-γ release assays and metagenomic next-generation sequencing for diagnosis of pulmonary tuberculosis: a retrospective study
title_sort combining interferon γ release assays and metagenomic next generation sequencing for diagnosis of pulmonary tuberculosis a retrospective study
topic TB-IGRA
Tuberculosis
mNGS
IFN-γ
Sputum smears
url https://doi.org/10.1186/s12879-024-10206-5
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