关键词: 分枝杆菌, 结核, 乙胺丁醇, 抗药性, 细菌, 戊糖基转移酶类, Meta分析

Abstract: Objective Using a Meta-analysis to evaluate the diagnostic value of PCR-DNA sequencing for the detection of embB gene mutations in Mycobacterium tuberculosis. Methods The relevant studies were searched in PubMed, Web of Science, OVID, Cochrane library, China National Knowledge Infrastructure (CNKI), Wanfang and Weipu datebase. At first, 767 citations were identified from all researches, 566 studies were obtained after excluding duplicate citations, 477 studies were preliminarily excluded by reading the titles and abstracts of all studies，and the residual 89 were included into screening full text, 18 independent studies were included at last. QUADAS-2 (quality assessment of diagnostic accuracy studies) was used to assess the quality of included studies, heterogeneity was analyzed using Q tests. Using Meta-Disc (version 1.4) to count statistical measures including pooled sensitivity, pooled specificity, diagnostic odds ratio (DOR), etc.. Results The pooled sensitivities (95% confidence interval (CI)) of PCR-DNA sequencing for detecting the mutations of embB306 codon, combination of embB306 and 406 codons, and combination of embB306, 406 and 497 codons were 0.56 (0.53-0.59), 0.60 (0.56-0.64), 0.76 (0.70-0.81), respectively. Their pooled specificities (95%CI) were 0.93 (0.92-0.94),0.89 (0.86-0.91), 0.89 (0.83-0.93), respectively. The DOR were 17.59 (9.35-33.10), 15.24 (5.51-42.11), 33.69 (4.53-250.90), respectively.  Conclusion The summarized specificity of PCR-DNA sequencing for detecting the mutations of embB 306,406，497 codons in Mycobacterium tuberculosis was high, and it was appropriate choice for detecting drug resistance to ethambutol.

Key words: Mycobacterium tuberculosis, Ethambutol, Drug resistance, bacterial, Pentosyltransferases, Meta-analysis