关键词: 结核分枝杆菌, 利福平, 寡核苷酸序列分析, 结核, 抗多种药物性, 细菌蛋白质类, Meta分析

Abstract: Objective To systematically review the diagnostic accuracy of gene chip in identifying rifampicin (RFP) resistance Mycobacterium tuberculosis (Mtb)，and to provide the evidence for the clinical use of gene chip in detection of RFP-resistance Mtb. Methods We electronically searched The Cochrane Library (Issue 1, 2014), PubMed, EMbase, Wanfang Data, CNKI from the date that the database was established to February 2014. In order to find any publications which are related to detection of RFP-resistance Mtb by using gene chip, the search key terms in English and Chinese were designed as follows: tuberculosis, tuberculosis and drug resistance, tuberculosis and drug resistance and gene chip, tuberculosis and drug resistance and gene chip and rifampicin. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the quality of methodology of the included studies according to the QUADAS items. The Meta-DiSc software (version 1.4) was used to conduct pooling on sensitivity (SEN), specificity (SPE), positive likelihood ratio (+LR), and negative likelihood ratio (-LR). Heterogeneity test was performed and the summary receiver operating characteristic (SROC) curve was drawn and area under curve (AUC) was calculated. Results A total of 223 publications were found. Finally, 22 articles (including one article from multicenter study) and 25 studies were included into the review，which involved 4879 Mtb isolates (including 1314 RFP-resistant strains, 3565 susceptible strains and the standard strain H37Rv). The results of Meta-analysis showed that, compared with the traditional drug sensitivity test, SEN of gene chip in detection of RFP-resistance Mtb was 0.89 (95%CI (0.87－0.91)), SPE was 0.98 (95%CI (0.97－0.98)), +LR was 30.89 (95%CI (22.15－43.06)), -LR was 0.10 (95%CI (0.07－0.15)), diagnostic OR was 354.06 (95%CI (212.09－591.07)), AUC was 0.9833. Conclusion Gene chip has a good value in detection of RFP-resistance Mtb. If the traditional drug sensitivity test is regarded as a gold standard, gene chip has high sensitivity, high specificity and high diagnostic OR value. It can be used as a clinical supplementary method of drug sensitivity test.

Key words: Mycobacterium tuberculosis, Rifampin, Oligonucleotide array sequence analysis, Tuberculosis, multidrug-resistant, Bacterial proteins, Meta-analysis