Nanopore-based targeted next-generation sequencing (tNGS): a versatile technology specialized in detecting low bacterial load clinical specimens

Previous studies have mainly used nanopore based targeted next-generation sequencing (tNGS) to detect respiratory specimens and evaluate their diagnostic efficacy for pulmonary tuberculosis. However, the enormous potential of tNGS seems to have not been fully explored: the key technological advantage of tNGS lies in its ability to target and enrich nucleic acid and resistance genes of MTB/NTM in clinical specimens through specific capture techniques, in order to obtain more data information for detection. This indicates that tNGS can provide laboratory evidence for the clinical diagnosis of low bacterial load tuberculosis (such as smear-negative tuberculosis and extrapulmonary tuberculosis). In addition, tNGS can directly identify the strains of mycobacteria, saving time and effort, and providing better diagnosis and treatment opportunities for patients with mycobacterial infections. Therefore, our study not only focused on respiratory specimens, but also included various pathological tissue samples (such as cerebrospinal fluid, etc.) to elucidate the clinical value of tNGS in diagnosing (drug-resistant) tuberculosis and identifying bacterial strains.