Value of Xpert MTB/RIF Using Bronchoalveolar Lavage Fluid for the Diagnosis of Pulmonary Tuberculosis: a Systematic Review and Meta-analysis
| Autor: | Dan-Feng Li, Yuan-qing Pan, Hong-Chao Liu, Xi-Yi Zhao, Yu-lu Gao, Changtai Zhu |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Context (language use) Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Pulmonary tuberculosis Internal medicine Drug Resistance Bacterial medicine Humans 030212 general & internal medicine Child Reference standards Antibiotics Antitubercular Tuberculosis Pulmonary medicine.diagnostic_test business.industry Area under the curve Mycobacterium tuberculosis Confidence interval Bronchoalveolar lavage 030228 respiratory system Meta-analysis Diagnostic odds ratio Minireview Rifampin business Bronchoalveolar Lavage Fluid |
| Zdroj: | J Clin Microbiol |
| ISSN: | 1098-660X |
| Popis: | The performance of Xpert MTB/RIF using bronchoalveolar lavage fluid (BAL) for the diagnosis of pulmonary tuberculosis (PTB) remains unclear. Therefore, a systematic review/meta-analysis was conducted. Studies published before 31 December 2019 were retrieved from the PubMed, Embase, and Web of Science databases using the keywords "pulmonary tuberculosis," "Xpert MTB/RIF," and "BAL." Two independent evaluators extracted the data and assessed the bias risk of the included studies. A random-effects model was used to calculate the overall sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR), and the area under the curve (AUC), as well as the respective 95% confidence intervals (CIs). Nineteen trials involving 3,019 participants met the inclusion criteria. Compared to the culture method, the pooled sensitivity, specificity, PLR, NLR, DOR, and the AUC with 95% CIs of Xpert MTB/RIF were 0.87 (0.84 to 0.90), 0.92 (0.91 to 0.93), 10.21 (5.78 to 18.02), 0.16 (0.12 to 0.22), 78.95 (38.59 to 161.53), and 0.9467 (0.9462 to 0.9472), respectively. Relative to the composite reference standard, the observed values were 0.69 (0.65 to 0.72), 0.98 (0.98 to 0.99), 37.50 (18.59 to 75.62), 0.30 (0.21 to 0.43), 171.98 (80.82 to 365.96), and 0.9691 (0.9683 to 0.9699), respectively. All subgroups, except children, showed high sensitivity and specificity. In conclusion, the use of Xpert MTB/RIF in the context of BAL samples has a high diagnostic performance for PTB (except for children) and may serve as an alternative rapid diagnostic tool. |
| Databáze: | OpenAIRE |
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