Rapid and effective diagnosis of tuberculosis and rifampicin resistance with Xpert MTB/RIF assay: A meta-analysis
Rapid and effective diagnosis of tuberculosis and rifampicin resistance with Xpert MTB/RIF assay: A meta-analysis
复制标题
使用 Xpert MTB/RIF 检测快速有效地诊断结核病和利福平耐药性：荟萃分析
DOI：
10.1016/j.jinf.2012.02.012
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发表时间：
2012-06-01
影响因子：
28.2
通讯作者：
Chen, Ming
中科院分区：
文献类型：
--
作者：
Chang, Kai;Lu, Weiping;Chen, Ming
目的：Xpert MTB/RIF（Cepheid）检测试剂盒已用于结核病（TB）和RIF耐药的诊断。Meta分析被用来建立Xpert MTB/RIF检测诊断TB和RIF-resistance.Methods的总体准确性：根据Pubmed和Embase的综合检索，我们确定了所有文章的结果数据估计诊断准确性与Xpert MTB/RIF检测。采用双变量随机效应方法计算敏感性、特异性、诊断优势比（DOR）和ROC曲线下面积（AUC）的汇总估计值。结果：荟萃分析包括18项研究（10,224例疑似标本）。肺结核（PTB）的敏感性、特异性和DOR/AUC的总体估计值分别为90.4%（95%CI 89.2%-91.4%）、98.4%（95%CI 98.0%-98.7%）和328.3/0.9822。检测RIF耐药的敏感性、特异性和DOR/AUC分别为94.1%、97.0%和177.8/0.9832。对于肺外结核，总的合并敏感性为80.4%，特异性为86.1%。亚组分析结果显示，Xpert MTB/RIF检测试剂盒对涂阳标本的准确性较高，对成人结核病的诊断敏感性高于儿童（90.8%比74.3%）。(c)2012年英国感染协会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: Xpert MTB/RIF (Cepheid) assay has been introduced for the diagnosis of tuberculosis (TB) and RIF-resistance. The meta-analysis was used to establish the overall accuracy of Xpert MTB/RIF assay for diagnosing TB and RIF-resistance.Methods: Based on comprehensive searches of the Pubmed and Embase, we identified outcome data from all articles estimating diagnostic accuracy with Xpert MTB/RIF assay. A summary estimation for sensitivity, specificity, diagnostic odds ratios (DOR) and the area under the summary ROC curve (AUC) was calculated by using the bivariate random-effects approach.Results: The meta-analysis included 18 studies (10,224 suspected specimens). The summary estimate was 90.4% (95%CI 89.2%-91.4%) for sensitivity, 98.4% (95%CI 98.0%-98.7%) for specificity and 328.3/0.9822 for DOR/AUC in pulmonary tuberculosis (PTB). The sensitivity, specificity and DOR/AUC of detecting RIF-resistance were 94.1%, 97.0% and 177.8/0.9832, respectively. For extrapulmonary tuberculosis, the overall pooled sensitivity was 80.4% and specificity was 86.1%. The findings in subgroup analysis were as follows: the accuracy of Xpert MTB/RIF assay is higher in smear-positive specimens and the sensitivity of diagnosing PTB in adults was higher than that in children (90.8% versus 74.3%).Conclusions: TB and RIF-resistance can be rapidly and effectively diagnosed with Xpert MTB/RIF assay. (c) 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.