The diagnostic value of targeted next-generation sequencing for smear-negative and sputum-scarce pulmonary tuberculosis

Objective To evaluate the diagnostic performance of targeted next-generation sequencing (tNGS) in pulmonary tuberculosis (PTB). Methods This retrospective study included 164 suspected PTB patients admitted to Anhui Chest Hospital between October 2022 and October 2024. All patients were smear-negative or sputum-scarce. Clinical specimens were tested simultaneously with tNGS, SAT-TB, GeneXpert MTB/RIF, and Mycobacterium tuberculosis (MTB) culture. Results Among 108 diagnosed PTB patients, the sensitivity of tNGS was significantly superior to that of other methods. The negative predictive value (NPV) and accuracy of tNGS were 66.67% and 82.93%, which were superior to other methods. In bronchoalveolar lavage fluid (BALF) specimens, the positive detection rate of tNGS reached 48.12%, significantly higher than that of other methods (P Conclusions tNGS demonstrates superior diagnostic performance for tuberculosis diagnosis, particularly in alternative specimens such as BALF and pleural effusion.