Abstract:

Objective To systematically evaluate the diagnostic value of GeneXpert MTB/RIF assay for bone and joint tuberculosis. Methods Relevant literatures on the diagnosis of bone and joint tuberculosis by GeneXpert MTB/RIF assay were collected by searching Wanfang, VIP, China National Knowledge Infrastructure, PubMed, Embase, and Cochrane Library databases from establishment to May 2020, and then literature screening, data extraction and quality evaluation were performed independently by two researchers. Reman 5.3 and MetaDisc 1.4 software were used for literature quality evaluation and Meta-analysis, respectively. Results A total of 350 literatures were retrieved, and 24 literatures from 4 countries were screened out according to the inclusion and exclusion criteria, including 3966 clinical specimens. Meta-analysis showed that compared to the comprehensive clinical diagnosis (CRS) as the reference standard, the pooled sensitivity and specificity of GeneXpert MTB/RIF assay for diagnosing the bone and joint tuberculosis were 82.9% (95%CI: 81.4%-84.3%) and 86.3% (95%CI: 84.3%-88.2%), respectively. Based on MTB culture and absolute concentration method drug sensitivity test (DST) as the gold standard, the pooled sensitivity and specificity were 93.9% (95%CI: 92.2%-95.2%) and 52.3% (95%CI: 49.9%-54.6%), respectively. GeneXpert MTB/RIF assay also had high sensitivity (89.5%, 95%CI: 87.5%-91.4%) and specificity (89.9%, 95%CI: 85.6%-93.2%) in the diagnosis of rifampin (RIF)-resistant bone and joint tuberculosis. Conclusion GeneXpert MTB/RIF assay has a high diagnostic value for bone and joint tuberculosis and RIF-resistant bone and joint tuberculosis. It can be used as an effective method for the rapid diagnosis of bone and joint tuberculosis.

Key words: Tuberculosis, osteoarticular, Nucleic acid amplification techniques, Nucleic acid probes, Diagnosis, Meta-analysis as topic