Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology

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pISSN 2288-0585 eISSN 2288-6850

A Systematic Review on the Effectiveness of Detection of M. tuberculosis and Rifampin Resistance Using Xpert MTB/RIF

Original article

Annals of Clinical Microbiology (Ann Clin Microbiol) 2014 June, Volume 17, Issue 2, pages 42-49.

https://doi.org/10.5145/ACM.2014.17.2.42

A Systematic Review on the Effectiveness of Detection of M. tuberculosis and Rifampin Resistance Using Xpert MTB/RIF

Ji-Young Jeong1, Seon-Heui Lee1, Sunyoung Jang2
1Health Technology Assessment Department, National Evidence-based Healthcare Collaborating Agency, Seoul, 2Department of Nursing, Hanseo University, Seosan, Korea

Abstract

Background: The purpose of this study was to evaluate the 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. (Ann Clin Microbiol 2014;17:42-49)

Keywords

Meta-analysis, Multidrug-resistant, Polymerase chain reaction, Rifampin, Tuberculosis