title: Molecular analysis of the rpsL gene for rapid detection of streptomycin-resistant Mycobacterium tuberculosis: a meta-analysis.
abstract: BACKGROUND
  Drug-resistant Mycobacterium tuberculosis (MTB) is a major threat to tuberculosis (TB) control programs and public health. Most conventional methods of drug susceptibility testing (DST) are precise but time-consuming. Molecular analysis of the rpsL gene has been used widely in diagnosing streptomycin-resistant MTB since it is rapid and specific. The aim of the present study was to perform a meta-analysis to assess the accuracy of molecular assay of the rpsL gene for the rapid detection of streptomycin-resistant MTB.
  
  
  METHODS
  We searched PubMed, Web of Science, and EBSCO databases for studies that applied a molecular assay of the rpsL gene to detect streptomycin-resistant MTB with a conventional method as the reference. The sensitivity and specificity were pooled by a random effect model using Meta-DiSc software. A summary receiver operating characteristic curve (SROC) was applied to summarize the diagnostic accuracy.
  
  
  RESULTS
  A total of 22 studies involving 2618 specimens with 1372 streptomycin-resistant and 1246 streptomycin-susceptible specimens met our inclusion criteria. The overall sensitivity and specificity estimates were 0.64 (95% confidence interval (CI) 0.61-0.66) and 1.00 (95% CI 0.99-1.00), respectively. The area under the SROC curve was 0.9069 and the Cochrane (Q*) index was 0.8387.
  
  
  CONCLUSIONS
  This meta-analysis reveals that molecular assay of the rpsL gene is a reliable and useful method for the detection of streptomycin-resistant MTB.
authors.affiliation: From the Faculty of Environmental Science and Engineering, Kunming University of Science and Technology.
authors.forename: Jing
authors.initials: J
authors.lastname: He
authors.forename: Baosheng
authors.initials: B
authors.lastname: Zhu
authors.forename: Zhaojie
authors.initials: Z
authors.lastname: Yang
authors.forename: Binbin
authors.initials: B
authors.lastname: Hu
authors.forename: Lianbing
authors.initials: L
authors.lastname: Lin
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics*; D012269:Ribosomal Proteins / Q000235:genetics*; D012680:Sensitivity and Specificity; D013307:Streptomycin / Q000494:pharmacology*; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis*
chemical_list: D000995:Antitubercular Agents; D012269:Ribosomal Proteins; D013307:Streptomycin
keywords: Molecular analysis; Mycobacterium tuberculosis; meta-analysis; rpsL; streptomycin