{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:25:32Z","timestamp":1787030732092,"version":"build-2736575974"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tuberculosis (TB) remains a global health threat, which is complicated by challenges in distinguishing TB from nontuberculous mycobacteria (NTM) infections and drug resistance. Conventional diagnostics (including culture, Xpert MTB\/RIF, AFB smear, T-SPOT.TB, etc.) are limited by inadequate differentiation of TB and NTM, incomplete resistance profiling, and prolonged turnaround times.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicenter study enrolled 130 patients with suspected mycobacterial infection between August 2023 and June 2024 at two tertiary hospitals in China. Patients were classified as TB (n=91), NTM (n=18), Other (n=17) and Mixed infection (n=4) based on a composite reference standard (final clinical diagnosis) established independently of targeted next-generation sequencing (tNGS) results. Performance of tNGS versus conventional methods was evaluated across different sample types. Diagnostic performance, drug-resistance detection, therapeutic impact and clinical outcomes were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall agreement of tNGS detection with clinical diagnoses of pathogens was 80.9% in sputum and 71.3% in bronchoalveolar lavage fluid (BALF), exceeding conventional methods (which remained below 55%). Critically, tNGS effectively distinguished TB from NTM, with diagnostic sensitivity of 84.0% (95% CI, 75.0%\u201390.8%) for TB and 90.5% (95% CI, 69.6%\u201398.8%) for NTM, and specificity of 100.0% (95% CI, 90.3%\u2013100.0%) for TB and 99.1% (95% CI, 95.0%\u2013100.0%) for NTM. tNGS simultaneously detected resistance-associated variants relevant to 11 antimycobacterial drugs within approximately 24 hours. Treatment regimens for 52 patients (41.3%) were adjusted following tNGS reporting. Of these, 82.7% showed subsequent clinical improvement, however, these outcome data remain descriptive and do not establish causality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>tNGS enables rapid, accurate, and comprehensive diagnosis of mycobacterial infections, reliably differentiates TB from NTM, and provides drug-resistance profiles to inform therapy, with the potential to assist in optimizing clinical management of TB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1818202","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:21Z","timestamp":1787027301000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical utility of targeted next-generation sequencing for rapid detection, species differentiation, drug resistance profiling, and prognostic evaluation in Mycobacterium tuberculosis: a multi-center retrospective cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Li","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Tuberculosis, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingde","family":"Ni","sequence":"additional","affiliation":[{"name":"Linyi People\u2019s Hospital","place":["Linyi, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Yang","sequence":"additional","affiliation":[{"name":"Dinfectome Inc.","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Shi","sequence":"additional","affiliation":[{"name":"School of Information Engineering, Changsha Medical University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuwu","family":"Liu","sequence":"additional","affiliation":[{"name":"Linyi People\u2019s Hospital","place":["Linyi, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Ni","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical College of Guangxi Medical University","place":["Nanning, Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunhui","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Tuberculosis, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1186\/s12879-024-09036-2","article-title":"Risk factors for diagnosis and treatment delay among patients with multidrug-resistant tuberculosis in Hunan Province, China","volume":"24","author":"Akalu","year":"2024","journal-title":"BMC Infect. 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