Resazurin microtiter assay for isoniazid, rifampicin, ethambutol and streptomycin resistance detection in Mycobacterium tuberculosis : Updated meta-analysis

• Published in: International journal of mycobacteriology Vol. 3; no. 4; pp. 230 - 241
• Main Authors: Coban, Ahmet Yilmaz, Deveci, Aydin, Sunter, Ahmet Tevfik, Palomino, Juan Carlos, Martin, Anandi
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-12-2014
• Subjects: Infectious Disease; MDR; Medical Education; Meta-analysis; Mycobacterium tuberculosis; Resazurin assay; Systematic review; XDR; Resazurin assay; Systematic review; MDR; Mycobacterium tuberculosis; XDR; Meta-analysis
• ISSN: 2212-5531; 2212-554X
• DOI: 10.1016/j.ijmyco.2014.09.002

Abstract Aims The present meta-analysis aims to assess the evidence regarding the diagnostic accuracy and performance characteristics of the colorimetric redox indicator (CRI) assay with a special emphasis on the use of the resazurin microtiter assay (REMA) for determination of primary anti-tuberculosis drug resistance. Subject and methods By updating previous literature searches in Medline PubMed, ISI Web, Web of Science and Google academic databases of the REMA test for determination of primary anti-tuberculosis drug resistance, this meta-analysis includes 14 studies for isoniazid (INH); 15 studies for rifampicin (RIF); 6 studies for streptomycin (STR); and 5 studies for ethambutol (EMB). SROC curve analysis was performed for meta-analysis and diagnostic accuracy was summarized. Results Pooled sensitivity was 96% (94–98%) for INH, 97% (95–98%) for RIF, 92% (87–96%) for EMB and 92% (88–95%) for STR. Pooled specificity for INH, RIF, EMB and STR was 96% (95–98%), 99% (98–99%), 86% (81–89%) and 90% (87–93%), respectively. Susceptibility testing results had been obtained in 8–9 days. Conclusion In conclusion, REMA seems to be a reliable test for the determination of multi-drug resistant (MDR) isolates in laboratories with limited resources. However, few studies for STR and EMB have been found, and cost-effectiveness studies need to be determined to recommend its widespread use.