Diagnostic Value of Nanopore-Based Targeted Sequencing Technology for Subclinical Tuberculosis

Background Subclinical Tuberculosis (TB), with low bacterial loads and non-specific symptoms, is difficult to diagnose and promotes transmission. This study aimed to evaluate the diagnostic performance of nanopore-based targeted sequencing (NTS) for subclinical TB in comparison with Mycobacteria Growth Indicator Tube (MGIT) culture and GeneXpert MTB/RIF (Xpert MTB/RIF) assays. Methods This retrospective research included 103 subclinical TB suspects. We tested sputum, bronchoalveolar lavage fluid, or pleural effusion from each patient using NTS, MGIT culture, and Xpert. Diagnostic performance was assessed using a composite standard. Results NTS exhibited higher sensitivity (90.9%) than MGIT culture (40.9%) and Xpert MTB/RIF (50.0%). It had a larger area under the curve (AUC) of 0.923 than Xpert (0.731) and MGIT culture (0.667), as well as an impressive negative predictive value (97.4%) and accuracy (93.2%). Conclusion NTS shows better diagnostic accuracy for subclinical TB than conventional approaches, efficiently identifying cases with low bacterial burdens. It could help find cases of TB earlier, closing the gap in TB control.