ArticleFrontiers in medicine2026
Nanopore-targeted sequencing for rapid and accurate diagnosis of tuberculous serous effusions: a prospective evaluation across pleural, peritoneal, and pericardial fluids.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Diagnosing tuberculous serous effusions involving the pleura, peritoneum, and pericardium remains a clinical challenge, primarily due to the paucibacillary nature of such infections and the suboptimal sensitivity of conventional diagnostic modalities. This study aimed to evaluate the diagnostic performance of nanopore-targeted sequencing (NTS) for detecting the Methods: A prospective cohort study was conducted on patients presenting with serous effusions of suspected tuberculous origin. Effusion samples (pleural, peritoneal, and pericardial) were collected via thoracentesis, paracentesis, or pericardiocentesis, respectively. All samples underwent a panel of standard tests, including acid-fast bacilli (AFB) smear microscopy, mycobacterial culture, Xpert MTB/RIF assay, and biochemical analyses (including adenosine deaminase [ADA] activity detection). The diagnostic performance of NTS was systematically evaluated and compared against both microbiological reference standards and composite clinical diagnostic criteria. Results: A total of 119 patients with serous effusions were enrolled, including 89 cases of tuberculous effusions and 30 cases of non-tuberculous effusions. The overall positive rates of AFB smear microscopy, MTB culture, and Xpert MTB/RIF assay were markedly low, at 1.12, 8.89, and 12.35%, respectively. NTS exhibited significantly superior sensitivity (61.8%) compared with other conventional microbiological tests (T-SPOT, Xpert MTB/RIF, and MTB culture; all Conclusion: NTS demonstrates substantially higher sensitivity than conventional microbiological methods for the rapid identification of tuberculous serous effusions. Its unique ability to directly detect MTBC DNA and drug resistance markers in low-bacillary-load serous fluids (pleural, peritoneal, and pericardial effusions) renders it particularly valuable for the early and precise diagnosis of tuberculous serous effusions, and it has the potential to guide the timely initiation of targeted anti-tuberculosis therapy.
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