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首页> 外文期刊>Journal of Clinical Microbiology >High-Resolution Melting Curve Analysis for Rapid Detection of Rifampin Resistance in Mycobacterium tuberculosis: a Meta-Analysis
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High-Resolution Melting Curve Analysis for Rapid Detection of Rifampin Resistance in Mycobacterium tuberculosis: a Meta-Analysis

机译：快速检测结核分枝杆菌对利福平耐药的高分辨率熔解曲线分析：一项荟萃分析

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A rapid, simple, accurate, and affordable method for the detection of drug-resistant tuberculosis is very critical for the selection of antimicrobial therapy and management of patient treatment. High-resolution melting curve analysis has been used for the detection of rifampin resistance in Mycobacterium tuberculosis and has shown promise. We did a systematic review and meta-analysis of published studies to evaluate the accuracy of high-resolution melting curve analysis for the detection of rifampin resistance in clinical M. tuberculosis isolates. We searched the PubMed, BIOSIS Previews, and Web of Science databases to identify studies and included them according to predetermined criteria. We used the DerSimonian-Laird random-effects model to calculate pooled measures and applied Moses' constant for linear models to fit the summary receiver operating characteristic curve. According to the selection criteria, most of the identified studies were excluded, and only seven studies were included in the final analysis. The overall sensitivity of the high-resolution melting curve analysis was 94% (95% confidence interval [CI], 92% to 96%), and the overall specificity was very high at 99% (95% CI, 98% to 100%). The values for the pooled positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 63.39 (95% CI, 30.21 to 133.00), 0.06 (95% CI, 0.04 to 0.09), and 892.70 (95% CI, 385.50 to 2,067.24), respectively. There was no significant heterogeneity across all included studies for the measurements we evaluated. The summary receiver operating characteristic curve for the same data shows an area of 0.99 and a Q* value of 0.97. High-resolution melting curve analysis has high sensitivity and specificity for the detection of rifampin resistance in clinical M. tuberculosis isolates. This method might be a good alternative to conventional drug susceptibility tests in clinical practice.
机译：快速，简单，准确和负担得起的检测耐药性结核病的方法对于选择抗菌药物和管理患者治疗至关重要。高分辨率熔解曲线分析已用于检测结核分枝杆菌对利福平的耐药性，并显示出希望。我们对发表的研究进行了系统的综述和荟萃分析，以评估高分辨率熔解曲线分析在临床结核分枝杆菌中检测利福平耐药性的准确性。我们搜索了PubMed，BIOSIS Previews和Web of Science数据库以识别研究，并根据预定标准将其包括在内。我们使用DerSimonian-Laird随机效应模型来计算合并量度，并对线性模型应用Moses常数来拟合汇总的接收器工作特性曲线。根据选择标准，大多数已鉴定的研究被排除在外，最终分析中仅包括七项研究。高分辨率熔解曲线分析的整体灵敏度为94％（95％置信区间[CI]，从92％至96％），整体特异性非常高，为99％（95％CI，从98％至100％）。 ）。合并的阳性似然比，阴性似然比和诊断比值比的值分别为63.39（95％CI，30.21至133.00），0.06（95％CI，0.04至0.09）和892.70（95％CI，385.50至2,067.24） ）， 分别。在我们评估的所有纳入研究中，均未发现明显异质性。相同数据的接收器工作特性曲线摘要显示面积为0.99， Q *值为0.97。高分辨率熔解曲线分析对于检测临床结核分枝杆菌中的利福平耐药性具有很高的灵敏度和特异性。在临床实践中，该方法可能是常规药物敏感性测试的良好替代方法。

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