Clinical features of nontuberculous mycobacteria and diagnosis with nanopore targeted sequencing: a retrospective cohort study

作者：Xingyu Liu, Tianzhen Wang, Yicheng Guo, Yi Zeng, Weiwei Gao · 发表于：Annals of Clinical Microbiology and Antimicrobials · 年份：2026 · DOI：10.1186/s12941-026-00876-1 · 研究领域：Mycobacterium research and diagnosis、Tuberculosis Research and Epidemiology、Immunodeficiency and Autoimmune Disorders

BACKGROUND: Diagnosing pulmonary non-tuberculous mycobacterial (NTM) disease remains challenging, not only because its clinical manifestations often overlap with those of tuberculosis (TB), but also because its symptoms and signs-such as chronic cough, sputum production, fatigue, and weight loss-can closely resemble those of other common respiratory conditions, including chronic obstructive pulmonary disease (COPD), recurrent pulmonary infections, and chronic bronchitis. This symptomatic overlap often leads to delayed or misdiagnosis, a problem exacerbated by the time-consuming nature of confirmatory culture, which further impedes timely diagnosis.Against the backdrop of a rising incidence of NTM pulmonary disease, Nanopore Targeted Sequencing (NTS) emerges as a promising solution, enabling rapid and comprehensive pathogen detection. This study aims to evaluate the clinical utility of NTS, with a focus on its diagnostic performance, ability to delineate the pathogen spectrum, and reveal polymicrobial co-infections. METHODS: In this retrospective study, we analyzed 350 patients suspected with pulmonary NTM infection at Nanjing Second Hospital between 2023 and 2025. We evaluated clinical characteristics, pathogen profiles and co-infections. Bronchoalveolar lavage fluid (BALF), sputum, and tissue specimens were subjected to NTS. The diagnostic performance of NTS was assessed by comparing it with traditional methods, including acid-fast bacillus (AFB) smear, mycobacterial species...