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. 2024 Jun 11;14(6):e080904.
doi: 10.1136/bmjopen-2023-080904.

Using cerebrospinal fluid nanopore sequencing assay to diagnose tuberculous meningitis: a retrospective cohort study in China

Lihong Zhou  1 , Xingwu Zou  1 , Yan Yong  1 , Qin Hu  2
Affiliations

Using cerebrospinal fluid nanopore sequencing assay to diagnose tuberculous meningitis: a retrospective cohort study in China

Lihong Zhou et al. BMJ Open. .

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).

Design: Single-centre retrospective study.

Setting: The Tuberculosis Diagnosis and Treatment Center of Zhejiang Chinese and Western Medicine Integrated Hospital.

Participants: 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.

Conclusion: The diagnostic accuracy of the nanopore sequencing test was significantly higher than that of conventional testing methods used to detect TBM.

Keywords: Diagnostic microbiology; Neurology; Tuberculosis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow diagram presenting the classification of patients in the present study. AFB, acid-fast bacillus; MTB, Mycobacterium tuberculosis; RIF, rifampicin; TBM, tuberculous meningitis.
Figure 2
Figure 2
Venn diagram of positive tests compared with the composite reference standard. MTB, Mycobacterium tuberculosis; RIF, rifampicin.
See this image and copyright information in PMC

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