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Accuracy of line probe assays for the diagnosis of pulmonary and multidrug-resistant tuberculosis: a systematic review and meta-analysis
- Source :
- The European Respiratory Journal
- Publication Year :
- 2017
- Publisher :
- European Respiratory Society, 2017.
-
Abstract
- Only 25% of multidrug-resistant tuberculosis (MDR-TB) cases are currently diagnosed. Line probe assays (LPAs) enable rapid drug-susceptibility testing for rifampicin (RIF) and isoniazid (INH) resistance and Mycobacterium tuberculosis detection. Genotype MTBDRplusV1 was WHO-endorsed in 2008 but newer LPAs have since been developed. This systematic review evaluated three LPAs: Hain Genotype MTBDRplusV1, MTBDRplusV2 and Nipro NTM+MDRTB. Study quality was assessed with QUADAS-2. Bivariate random-effects meta-analyses were performed for direct and indirect testing. Results for RIF and INH resistance were compared to phenotypic and composite (incorporating sequencing) reference standards. M. tuberculosis detection results were compared to culture. 74 unique studies were included. For RIF resistance (21 225 samples), pooled sensitivity and specificity (with 95% confidence intervals) were 96.7% (95.6–97.5%) and 98.8% (98.2–99.2%). For INH resistance (20 954 samples), pooled sensitivity and specificity were 90.2% (88.2–91.9%) and 99.2% (98.7–99.5%). Results were similar for direct and indirect testing and across LPAs. Using a composite reference standard, specificity increased marginally. For M. tuberculosis detection (3451 samples), pooled sensitivity was 94% (89.4–99.4%) for smear-positive specimens and 44% (20.2–71.7%) for smear-negative specimens. In patients with pulmonary TB, LPAs have high sensitivity and specificity for RIF resistance and high specificity and good sensitivity for INH resistance. This meta-analysis provides evidence for policy and practice.<br />Line probe assays have high accuracy for detection of RIF resistance and INH resistance http://ow.ly/USX5305tqFV
- Subjects :
- 0301 basic medicine
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Tuberculosis
030106 microbiology
Antitubercular Agents
Microbial Sensitivity Tests
Gastroenterology
Sensitivity and Specificity
Mycobacterium tuberculosis
03 medical and health sciences
Internal medicine
Drug Resistance, Multiple, Bacterial
Genotype
Tuberculosis, Multidrug-Resistant
parasitic diseases
medicine
Isoniazid
Humans
Tuberculosis, Pulmonary
biology
business.industry
Sputum
Original Articles
biology.organism_classification
medicine.disease
bacterial infections and mycoses
Confidence interval
3. Good health
wf_20
Multiple drug resistance
Meta-analysis
Immunology
wf_220
wf_200
Rifampin
business
DNA Probes
Nucleic Acid Amplification Techniques
wf_300
Rifampicin
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 09031936
- Database :
- OpenAIRE
- Journal :
- The European Respiratory Journal
- Accession number :
- edsair.doi.dedup.....20c5b43cdff67c4a251d3db2c5963fd6