Precisión diagnóstica de tres pruebas moleculares para detectar la tuberculosis multirresistente

  • Nelson José Alvis-Zakzuk Grupo de Investigación en Economía de la Salud, Universidad de Cartagena, Cartagena, Colombia Observatorio Nacional de Salud, Instituto Nacional de Salud, Bogotá, D.C., Colombia
  • María de los Ángeles Carrasquilla Grupo de Investigación en Economía de la Salud, Universidad de Cartagena, Cartagena, Colombia ALZAK Foundation, Cartagena, Colombia
  • Verónica Jhajaira Gómez Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
  • Jaime Robledo Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
  • Nelson Rafael Alvis-Guzmán Grupo de Investigación en Economía de la Salud, Universidad de Cartagena, Cartagena, Colombia Grupo de Investigación en Gestión Hospitalaria y Políticas de Salud, Universidad de la Costa, Barranquilla, Colombia
  • José Mauricio Hernández Corporación para Investigaciones Biológicas, Universidad Pontificia Bolivariana, Medellín, Colombia
Palabras clave: tuberculosis, tuberculosis extensivamente resistente a drogas, tuberculosis resistente a múltiples medicamentos, sensibilidad y especificidad, revisión

Resumen

Introducción. La tuberculosis multirresistente (TB-MDR) y la extremadamente resistente (TB-XDR) constituyen un problema de salud pública a nivel mundial. Su detección oportuna permitiría reducir la carga de la enfermedad y su impacto económico en los sistemas de salud.
Objetivo. Revisar sistemáticamente la información relacionada con la precisión diagnóstica de tres pruebas moleculares para detectar la tuberculosis multirresistente y la extremadamente resistente.
Materiales y métodos. Se hizo una revisión sistemática de la literatura, según los lineamientos de Cochrane, de los estudios en población inmunocompetente relacionados con la precisión diagnóstica de tres pruebas moleculares para detectar la tuberculosis multirresistente y la extremadamente resistente. La búsqueda de los estudios publicados a partir del 2007 se hizo en Medline y Embase. La precisión diagnóstica de las pruebas se estableció con base en los valores máximos y mínimos de sensibilidad y especificidad, y en los valores predictivos positivos y negativos.
Resultados. Se detectaron ocho estudios sobre la precisión diagnóstica de la prueba GeneXpert MTB/RIF®, 12 sobre la de GenoType MTBDRplus® y 13 sobre la de GenoType MTBDRsl®. La especificidad de GeneXpert MTB/RIF® osciló entre 91 y 100 % y su sensibilidad, entre 33,3 y 100 %. La sensibilidad de GenoType MTBDRplus® varió entre 82 y 100 %, en tanto que la sensibilidad y la especificidad de GenoType® MTBDRsl fluctuaron entre 56 y 100 % y 21 y 100 %, respectivamente.
Conclusión. Según los estudios consultados, los tres métodos de diagnóstico evaluados presentaban una adecuada eficacia diagnóstica para detectar la tuberculosis multirresistente y la extremadamente resistente.

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Publicado
2017-09-01
Cómo citar
Alvis-Zakzuk, N., Carrasquilla, M., Gómez, V., Robledo, J., Alvis-Guzmán, N., & Hernández, J. (2017). Precisión diagnóstica de tres pruebas moleculares para detectar la tuberculosis multirresistente. Biomédica, 37(3), 397-407. https://doi.org/10.7705/biomedica.v37i3.3437
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