SynthesisBMC infectious diseases2009
Direct susceptibility testing for multi drug resistant tuberculosis: a meta-analysis.
Synthesis in BMC infectious diseases, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
74 citing papers in PubMed, 6 syntheses or guidelines pooled it, 175 citations in OpenAlex.
- GenoType MTBDRplus Assay for Rapid Detection of Multidrug Resistance in Mycobacterium tuberculosis: A Meta-Analysis.PloS one · 2016Pooled it
- Nitrate reductase assay for rapid detection of isoniazid, rifampin, ethambutol, and streptomycin resistance in Mycobacterium tuberculosis: a systematic review and meta-analysis.Journal of clinical microbiology · 2014Pooled it
- Meta-analysis to compare the accuracy of GeneXpert, MODS and the WHO 2007 algorithm for diagnosis of smear-negative pulmonary tuberculosis.BMC infectious diseases · 2013Pooled it
- Diagnostic accuracy and reproducibility of WHO-endorsed phenotypic drug susceptibility testing methods for first-line and second-line antituberculosis drugs.Journal of clinical microbiology · 2013Pooled it
- Systematic review of the performance of rapid rifampicin resistance testing for drug-resistant tuberculosis.PloS one · 2013Pooled it
- Promise versus reality: optimism bias in package inserts for tuberculosis diagnostics.Journal of clinical microbiology · 2012Pooled it
- Sentinel-Site-Based Surveillance ofAntibiotics (Basel, Switzerland) · 2025Article
- Diagnostic accuracy of direct drug susceptibility testing of second-line antitubercular drugs.Microbiology spectrum · 2025Article
- Drug resistance profile ofFrontiers in microbiology · 2025Article
- New insight in molecular detection of Mycobacterium tuberculosis.AMB Express · 2024Review
- Multiplex Accelerated PCR System for One-Step Helicobacter pylori cagA + Genotypes Detection: A Guide for Clinical Testing.Current microbiology · 2022Article
- Automatic cough classification for tuberculosis screening in a real-world environment.Physiological measurement · 2021Article
- The simple direct slide method is comparable to indirect Lowenstein Jensen proportion culture for detecting rifampicin resistant tuberculosis.Journal of medical microbiology · 2021Article
- Article
- Genotype®MTBDRplus and Xpert®MTB/RIF in the diagnosis of tuberculosis and resistant tuberculosis: cost analysis in a tertiary referral hospital.Revista da Sociedade Brasileira de Medicina Tropical · 2020Article
- Evaluation of GenoType MTBDRplus for the detection of drug-resistant Mycobacterium tuberculosis on isolates from Karachi, Pakistan.PloS one · 2019Article
- Evaluation of Microscopic observation drug susceptibility (MODS) assay as a rapid, sensitive and inexpensive test for detection of tuberculosis and multidrug resistant tuberculosis.Medical journal, Armed Forces India · 2019Article
- The occurrence and frequency of genomic mutations that mediate Isoniazid and Rifampicin resistance inMalawi medical journal : the journal of Medical Association of Malawi · 2018Article
- Evaluation of the GenoType MTBDRInfection and drug resistance · 2018Article
- Correlation between the BACTEC MGIT 960 culture system with Genotype MTBDRplus and TB-SPRINT in multidrug resistant Mycobacterium tuberculosis clinical isolates from Brazil.Memorias do Instituto Oswaldo Cruz · 2017Article
14 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOne of the challenges facing the tuberculosis (TB) control programmes in resource-limited settings is lack of rapid techniques for detection of drug resistant TB, particularly multi drug resistant tuberculosis (MDR TB). Results obtained with the conventional indirect susceptibility testing methods come too late to influence a timely decision on patient management. More rapid tests directly applied on sputum samples are needed. This study compared the sensitivity, specificity and time to results of four direct drug susceptibility testing tests with the conventional indirect testing for detection of resistance to rifampicin and isoniazid in M. tuberculosis. The four direct tests included two in-house phenotypic assays - Nitrate Reductase Assay (NRA) and Microscopic Observation Drug Susceptibility (MODS), and two commercially available tests - Genotype MTBDR and Genotype MTBDRplus (Hain Life Sciences, Nehren, Germany).
methodsA literature review and meta-analysis of study reports was performed. The Meta-Disc software was used to analyse the reports and tests for sensitivity, specificity, and area under the summary receiver operating characteristic (sROC) curves. Heterogeneity in accuracy estimates was tested with the Spearman correlation coefficient and Chi-square.
resultsEighteen direct DST reports were analysed: NRA - 4, MODS- 6, Genotype MTBDR - 3 and Genotype MTBDRplus - 5. The pooled sensitivity and specificity for detection of resistance to rifampicin were 99% and 100% with NRA, 96% and 96% with MODS, 99% and 98% with Genotype MTBDR, and 99% and 99% with the new Genotype MTBDRplus, respectively. For isoniazid it was 94% and 100% for NRA, 92% and 96% for MODS, 71% and 100% for Genotype MTBDR, and 96% and 100% with the Genotype MTBDRplus, respectively. The area under the summary receiver operating characteristic (sROC) curves was in ranges of 0.98 to 1.00 for all the four tests. Molecular tests were completed in 1 - 2 days and also the phenotypic assays were much more rapid than conventional testing.
conclusionDirect testing of rifampicin and isoniazid resistance in M. tuberculosis was found to be highly sensitive and specific, and allows prompt detection of MDR TB.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.