Al-Ateah et Level III-2 MGIT N=116 BAL specimens AFB (FL) 4 1 2 109 None reported al. () and/or L-J Xpert 5 0 1 110 Low risk of bias n=111 culture Kingdom of AFB –ve: Xpert 1 0 1 109 Saudi Arabia Malbruny et al. Level III-2 MGIT and N=40 specimens AFB (FL) 4 1 3 32 None reported () Coletsos 31 bronchial aspirates Xpert 7 0 0 33 Low risk of bias slants 9 BAL AFB + NAAT 7 1 0 32 France n=35 AFB –ve: Xpert 3 0 0 32 AFB = acid-fast bacilli; BAL = bronchoalveolar lavage; FL = fluorescent; HIV = human immunodeficiency virus; L-J = Lowenstein-Jensen; MGIT = Mycobacterium Growth Indicator Tubes; NAAT = nucleic acid amplification test; Xpert = GeneXpert MTB/RIF NAAT Table 77 Diagnostic accuracy of Xpert NAAT compared with AFB microscopy and culture in gastric aspirates Evidence Reference Study Population Tests Inconclusive results level and risk standard Country Samples of bias results results results results Bates et al. () Level III-2 MGIT N=788 gastric aspirates AFB (FL) 12 23 36 717 None reported culture from children Xpert 33 5 15 735 Low risk of Zambia bias Malbruny et al. Level III-2 MGIT and N=33 gastric aspirates AFB (FL) 3 0 2 28 None reported () Coletsos Xpert 5 0 0 28 Low risk of slants - AFB + NAAT 5 0 0 28 France bias n=30 AFB –ve: Xpert 2 0 0 28 Moure, Martin & Level III-2 MGIT N=6 gastric aspirates AFB –ve: Xpert 2 0 1 3 2/8 specimens had an Alcaide () and/or L-J Xpert indeterminate Some risk of culture result Spain bias 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
Al-Ateah et al. () Kingdom of Saudi Arabia Level III-2 Low risk of bias MGIT and/or L-J culture N=116 BAL specimens n=111 AFB (FL) Xpert AFB –ve: Xpert 4 5 1 1 0 0 2 1 1 109 110 109 None reported Malbruny et al. () France Level III-2 Low risk of bias MGIT and Coletsos slants N=40 specimens 31 bronchial aspirates 9 BAL n=35 AFB (FL) Xpert AFB + NAAT AFB –ve: Xpert 4 7 7 3 1 0 1 0 3 0 0 0 32 33 32 32 None reported AFB = acid-fast bacilli; BAL = bronchoalveolar lavage; FL = fluorescent; HIV = human immunodeficiency virus; L-J = Lowenstein-Jensen; MGIT = Mycobacterium Growth Indicator Tubes; NAAT = nucleic acid amplification test; Xpert = GeneXpert MTB/RIF NAAT Table 77 Diagnostic accuracy of Xpert NAAT compared with AFB microscopy and culture in gastric aspirates Study Country Evidence level and risk of bias Reference standard Population Samples Tests results results results results Inconclusive results Bates et al. () Zambia Level III-2 Low risk of bias MGIT culture N=788 gastric aspirates from children AFB (FL) Xpert 12 33 23 5 36 15 717 735 None reported Malbruny et al. () France Level III-2 Low risk of bias MGIT and Coletsos slants N=33 gastric aspirates - n=30 AFB (FL) Xpert AFB + NAAT AFB –ve: Xpert 3 5 5 2 0 0 0 0 2 0 0 0 28 28 28 28 None reported Moure, Martin & Alcaide () Spain Level III-2 Some risk of bias MGIT and/or L-J culture N=6 gastric aspirates AFB –ve: Xpert 2 0 1 3 2/8 specimens had an Xpert indeterminate result 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
1234_FinalAssessmentReport-accessible.docx