The diagnostic value of third-generation nanopore sequencing in non-tuberculous mycobacterial infections

Background: This study aimed to investigate the diagnostic value of nanopore sequencing technology in non-tuberculous mycobacterial pulmonary disease (NTMPD) and compare it with traditional culture methods.Methods: A retrospective analysis was conducted on 225 suspected NTMPD patients admitted to the Fourth People's Hospital of Nanning City from January 2022 to August 2024. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), agreement rate, kappa coefficient, and area under the receiver operating characteristic curve (AUC) of nanopore sequencing, culture, and combined diagnostic methods were compared to evaluate their diagnostic performance. Additionally, patients were stratified into different groups to explore the detection of NTM by nanopore sequencing under different pathogen concentrations and in cases of concurrent Mycobacterium tuberculosis (MTB) infection.