KMID : 0829320140170020042
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Korean Journal of Clinical Microbiology 2014 Volume.17 No. 2 p.42 ~ p.49
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A Systematic Review on the Effectiveness of Detection of M. tuberculosis and Rifampin Resistance Using Xpert MTB/RIF
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Jeong Ji-Young
Lee Seon-Heui Jang Sun-Young
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Abstract
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Background: The purpose of this study was to evaluatethe effectiveness of Xpert MTB/RIF (Cepheid,USA) in the detection of Mycobacterium tuberculosis and to determine rifampin resistance.
Methods: The literature review covered the period from 16 August 2011 to 1 October 2011, and eight domestic databases and foreign databases including Ovid-Medline, Embase, and Cochrane Library were used. Key words, such as ¡®Rifampin, Polymerase Chain Reaction,¡¯ ¡®GeneXpert¡¯ and ¡®Xpert MTB-RIF¡¯were used to search a total of 1,385 documents. The SIGN (Scottish Intercollegiate Guidelines Network) tool was used to evaluate the quality of the 20 selected studies.
Results: Test accuracy for the detection of M. tuberculosis was assessed on the basis of 20 studies using the M. tuberculosis culture test as the reference standard. The acid-fast bacteria smearing test had a sensitivity in the range of 0.69-1.00, specificity in the range of 0.72-1.00 and test accuracy in the range of 0.75-1.00. Test accuracy regarding rifampin resistance was assessed on the basis of 17 studies.Using an anti-tuberculosis agent sensitivity test as the reference standard, the sensitivity, specificity and test accuracy of real-time, nested PCR were in the ranges of 0.75-1.00, 0.96-1.00 and 0.95-1.00, respectively.
Conclusion: Xpert MTB/RIF is a useful test for patients suspected of having rifampin-resistant tuberculosis.
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KEYWORD
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Meta-analysis, Multidrug-resistant, Polymerase chain reaction, Rifampin, Tuberculosis
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