Fig. 1

Flowchart showing steps of MTB-detection methods used in this study. BALF samples collected from patients were each aliquoted into five tubes that were subjected to separate tests that included MGIT 960 culture (one sample), Xpert (one sample) and three mNGS tests (three samples) that included conventional mNGS (one sample), HDA-mNGS (one sample) and HDA-Nanopore (one sample). The conventional mNGS library was constructed without depletion of human DNA, whereas MGI and Nanopore libraries were constructed after human DNA was removed from the HDA-mNGS and HDA-Nanopore pipelines. Sequencing, bioinformatic analysis and reporting PTB diagnostic results were interpreted based on standard TB cut-offs. The mean sequence number outputs obtained using conventional mNGS, HDA-mNGS and HDA-Nanopore were 56.84M, 28.16M and 103.74K. Created in BioRender [16]