title: Diagnosis of Drug Resistance to Fluoroquinolones, Amikacin, Capreomycin, Kanamycin and Ethambutol with Genotype MTBDRsl Assay: a Meta-Analysis.
abstract: BACKGROUND
  The Genotype MTBDRsl is a new-generation PCR-based line-probe assay for rapid identification of the resistance to the second-line antituberculosis drugs with a single strip. The aim of this meta-analysis was to evaluate the performance of Genotype MTBDRsl in detecting drug resistance to fluoroquinolones, amikacin, capreomycin, kanamycin and ethambutol in comparison with the phenotypic drug susceptibility test.
  
  
  METHODS
  We searched Pubmed, Embase and the Cochrane Library and calculated the sensitivity, the specificity, the positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), corresponding 95% confidence interval (CI), and the area under the summary receiver operating characteristic (SROC) curves (AUC), and tested heterogeneity in accuracy estimates with the Spearman correlation coefficient and Chi-square.
  
  
  RESULTS
  The summarized sensitivity (95% CI), specificity (95% CI), and AUC (standard error) were 0.869 (0.847-0.890), 0.973 (0.965-0.979) and 0.9690 (0.0188) for fluoroquinolones, 0.868 (0.829-0.900), 0.998 (0.994-0.999) and 0.9944 (0.0050) for amikacin, 0.879 (0.838-0.914), 0.970 (0.958-0.978) and 0.9791 (0.0120) for capreomycin, 0.501 (0.461-0.541), 0.991 (0.983-0.996) and 0.9814 (0.0114) for kanamycin and 0.686 (0.663-0.709), 0.871 (0.852-0.888) and 0.7349 (0.0639) for ethambutol, respectively.
  
  
  CONCLUSIONS
  The genotype MTBDRsl demonstrate excellent accuracy for detecting drug resistance to fluoroquinolones, amikacin, and capreomycin, but it may not be an appropriate choice for detection of kanamycin and ethambutol.
authors.affiliation: Department of Clinical Laboratory, Central Hospital of Wuhan, No. 26, Shengli Street, Jiangan District 430014, Hubei Province, PR China.
authors.forename: Xiaolu
authors.initials: X
authors.lastname: Mao
authors.affiliation: Department of Pharmacy, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei Province, PR China.
authors.forename: Zunqiong
authors.initials: Z
authors.lastname: Ke
authors.affiliation: Department of Central Laboratory, Central Hospital of Wuhan, Wuhan, Hubei Province, PR China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Shi
authors.affiliation: Department of Central Laboratory, Central Hospital of Wuhan, Wuhan, Hubei Province, PR China.
authors.forename: Shuiyi
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Clinical Laboratory, Central Hospital of Wuhan, Wuhan, Hubei, PR China.
authors.forename: Beibei
authors.initials: B
authors.lastname: Tang
authors.affiliation: Department of Clinical Laboratory, Central Hospital of Wuhan, Wuhan, Hubei, PR China.
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, Central Hospital of Wuhan, Wuhan, Hubei, PR China haohuang2010@126.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Huang
mesh_terms: D000583:Amikacin / Q000494:pharmacology; D000995:Antitubercular Agents / Q000494:pharmacology*; D002207:Capreomycin / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004977:Ethambutol / Q000494:pharmacology; D054908:Extensively Drug-Resistant Tuberculosis / Q000175:diagnosis / Q000382:microbiology; D024841:Fluoroquinolones / Q000494:pharmacology*; D060005:Genotyping Techniques / Q000379:methods*; D006801:Humans; D007612:Kanamycin / Q000494:pharmacology; D007613:Kanamycin Resistance; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D024841:Fluoroquinolones; D002207:Capreomycin; D007612:Kanamycin; D000583:Amikacin; D004977:Ethambutol