Alcaide () Some risk of and/or L-J bias culture Spain AFB = acid-fast bacilli; FL = fluorescent; L-J = Lowenstein-Jensen; MGIT = Mycobacterium Growth Indicator Tubes; NAAT = nucleic acid amplification test; Xpert = GeneXpert MTB/RIF NAAT Table 90 Diagnostic accuracy of NAAT compared with drug sensitivity testing for the detection of drug-resistant MTB infections Study Evidence Reference Population Tests Inconclusive results level and risk standard Country Samples of bias results results results results Carriquiry et al. Level III-1 DST N= 39 culture-positive Xpert RIF 6 3 0 30 None reported () sputum samples Low risk of Peru bias DST with N=125 culture-positive Vadwai et al. () Level III-2 Xpert RIF 39 5 1 80 None reported MGIT SIRE extrapulmonary India Low risk of specimens bias Kurbatova et al. Level III-2 DST N=99 culture-positive Xpert (conc) vs L-J or 57 1 5 38 10/109 specimens had () Xpert-valid sputum MGIT 45 2 5 30 invalid Xpert RIF results Low risk of specimens Xpert (conc) vs L-J DST 55 2 1 40 2/109 specimens had Russia bias Xpert (conc) vs MGIT contaminated MGIT DST DST 25/109 specimens had contaminated L-J DST Bates et al. () Level III-2 DST with N=52 culture-positive RIF resistance 6/788 specimens were MGIT SIRE gastric lavage contaminated and excluded Zambia Low risk of Xpert RIF 2 1 0 49 specimens from analysis bias Multi- drug resistance Xpert RIF 2 1 0 49 Lee et al. () Level III-2 DST on N=35 culture-positive Xpert RIF 2 0 0 33 None reported Ogawa Xpert-positive Korea Low risk of medium bronchoscopy samples bias Ioannidis et al. () Level III-2 GenoType N=32 culture-positive, Xpert RIF 3 1 0 28 None reported MTBDRplus GeneXpert-valid mixed Greece Low risk of and samples bias confirmed
Alcaide () Spain Some risk of bias and/or L-J culture AFB = acid-fast bacilli; FL = fluorescent; L-J = Lowenstein-Jensen; MGIT = Mycobacterium Growth Indicator Tubes; NAAT = nucleic acid amplification test; Xpert = GeneXpert MTB/RIF NAAT Table 90 Diagnostic accuracy of NAAT compared with drug sensitivity testing for the detection of drug-resistant MTB infections Study Country Evidence level and risk of bias Reference standard Population Samples Tests results results results results Inconclusive results Carriquiry et al. () Peru Level III-1 Low risk of bias DST N= 39 culture-positive sputum samples Xpert RIF 6 3 0 30 None reported Vadwai et al. () India Level III-2 Low risk of bias DST with MGIT SIRE N=125 culture-positive extrapulmonary specimens Xpert RIF 39 5 1 80 None reported Kurbatova et al. () Russia Level III-2 Low risk of bias DST N=99 culture-positive Xpert-valid sputum specimens Xpert (conc) vs L-J or MGIT Xpert (conc) vs L-J DST Xpert (conc) vs MGIT DST 57 45 55 1 2 2 5 5 1 38 30 40 10/109 specimens had invalid Xpert RIF results 2/109 specimens had contaminated MGIT DST 25/109 specimens had contaminated L-J DST Bates et al. () Zambia Level III-2 Low risk of bias DST with MGIT SIRE N=52 culture-positive gastric lavage specimens RIF resistance Xpert RIF Multi- drug resistance Xpert RIF 2 2 1 1 0 0 49 49 6/788 specimens were contaminated and excluded from analysis Lee et al. () Korea Level III-2 Low risk of bias DST on Ogawa medium N=35 culture-positive Xpert-positive bronchoscopy samples Xpert RIF 2 0 0 33 None reported Ioannidis et al. () Greece Level III-2 Low risk of bias GenoType MTBDRplus and confirmed N=32 culture-positive, GeneXpert-valid mixed samples Xpert RIF 3 1 0 28 None reported