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Keywords:

  • Mycobacterium tuberculosis;
  • Systematic review;
  • SROC;
  • Non-radioactive mycobacterium culture system

Abstract

Objective To evaluate available evidence on the diagnostic value of radioactivity-free cultivation and detection technologies for rapid detection of rifampicin resistance in Mycobacterium tuberculosis.

Methods A fully recursive literature search was conducted in PubMed, EMBASE, Biosis, Web of Science (all 1990–2010), CBMWeb (1978–2010), and Google Scholar. QUADAS items were used to evaluate the quality of included studies. Sensitivity, specificity, Summary receiver-operating curve SEN, SPE, SROC, and related techniques were used to assess the diagnostic value of radioactivity-free Mycobacterium tuberculosis cultivation and detection technologies.

Results Six studies were included in the final analysis. The MB/BacT, BACTEC MGIT 960, and Manual MGIT systems were highly sensitive and specific for detecting rifampicin-resistant TB. The summary SEN and summary SPE of the MB/BacT and BACTEC MGIT 960 systems were 100%, 99%, 100%, and 96%, respectively. The SROC of the BACTEC MGIT 960 system was 0.9943.

Conclusion We recommended that the BACTEC 460 system be replaced by MB/BacT or BACTEC MGIT 960 as the final diagnostic test for rifampicin resistance in Mycobacterium tuberculosis. More studies are needed on the diagnostic value of other radioactivity-free cultivation and detection technologies to reliably determine their sensitivity and specificity for this bacterium.