Application of Metagenomic Next-Generation Sequencing in Mycobacterium tuberculosis Infection

Abstract

The fight against Mycobacterium tuberculosis (MTB) has been going on for thousands of years, while it still poses a threat to human health. In addition to routine detections, metagenomic next-generation sequencing (mNGS) has begun to show presence as a comprehensive and hypothesis-free test. It can not only detect MTB without isolating specific pathogens but also suggest the co-infection pathogens or underlying tumor simultaneously, which is of benefit to assist in comprehensive clinical diagnosis. It also shows the potential to detect multiple drug resistance sites for precise treatment. However, considering the cost performance compared with conventional assays (especially Xpert MTB/RIF), mNGS seems to be overqualified for patients with mild and typical symptoms. Technology optimization of sequencing and analyzing should be conducted to improve the positive rate and broaden the applicable fields.

Delayed Diagnosis of Mycobacterium bovis bacillus Calmette-Guérin Periprosthetic Joint Infection Following Total Knee Arthroplasty

“…Despite its potential, mNGS may have reduced sensitivity in paucibacillary specimens, resulting in a low yield of genomic DNA available for sequencing. mNGS has demonstrated success in diagnosing MTB in various specimens, including pulmonary, cerebrospinal fluid, and other extrapulmonary specimens [ 36 , 37 ]. Huang et al.…”

Case report: Difficult diagnosis of Mycobacterium tuberculosis infection in patients after allogeneic hematopoietic stem cell transplantation: two case reports and a literature review

“…Studies have shown that mNGS is more suitable when the patient presents with unexplained manifestations beyond traditional assays or atypical symptoms, such as fever, dyspnea, and elevated inflammatory markers. It is also recommended when there is a strong suspicion of a multipathogen infection, in cases where the patient is in critical condition, and when timely and comprehensive detection results are crucially needed ( 22 ).…”

Testing of Biological Products: A Review of Alternative Non-microbiological Techniques for Mycobacterial Testing

“…The advent of next-generation sequencing (NGS) techniques brings a new opportunity for the detection of mycobacterial nucleic acids [58,59]. The limitations of previous-generation sequencing techniques [60] did not allow the use of sequencing as a routine method for mycobacterial detection.…”

“…Like other mycobacterial nucleic acids detection techniques, NGS techniques have diagnostic applications. The technology is useful to identify the species or strains involved in a disease and can provide information about possible drug resistances [59].…”