LBT Innovations Ltd., Adelaide, Australia.
Australian Centre for Visual Technologies, University of Adelaide, Adelaide, Australia.
Ann Lab Med. 2017 Nov;37(6):499-504. doi: 10.3343/alm.2017.37.6.499.
The application of image analysis technologies for the interpretation of microbiological cultures is evolving rapidly. The primary aim of this study was to establish whether the image analysis system named Automated Plate Assessment System (APAS; LBT Innovations Ltd., Australia) could be applied to screen urine cultures. A secondary aim was to evaluate differences between traditional plate reading (TPR) and the reading of cultures from images, or digital plate reading (DPR).
A total of 9,224 urine samples submitted for culture to three clinical laboratories, two in Australia and one in the USA, were included in the study. Cultures were prepared on sheep blood and MacConkey agar plates and read by panels of three microbiologists. The plates were then presented to APAS for image capture and analysis, and the images and results were stored for later review.
Image analysis of cultures using APAS produced a diagnostic sensitivity and specificity of 99.0% and 84.5%, respectively. Colonies were detected by APAS on 99.0% of blood agar plates with growth and on 99.5% of MacConkey agar plates. DPR agreed with TPR for colony enumeration on 92.1% of the plates, with a sensitivity of 90.8% and specificity of 92.8% for case designation. However, several differences in the classification of colony morphologies using DPR were identified.
APAS was shown to be a reliable screening system for urine cultures. The study also showed acceptable concordance between DPR and TPR for colony detection, enumeration, and case designation.
图像分析技术在微生物培养物解释中的应用正在迅速发展。本研究的主要目的是确定名为自动平板评估系统（APAS；澳大利亚 LBT 创新有限公司）的图像分析系统是否可用于筛选尿液培养物。次要目的是评估传统平板阅读（TPR）与图像或数字平板阅读（DPR）读取培养物之间的差异。
本研究共纳入来自澳大利亚的两个临床实验室和美国的一个临床实验室的 9224 份尿液样本进行培养。培养物在绵羊血琼脂平板和 MacConkey 琼脂平板上制备，并由三组微生物学家进行平板阅读。然后将平板提交给 APAS 进行图像采集和分析，并存储图像和结果以备后查。
使用 APAS 对培养物进行图像分析的诊断灵敏度和特异性分别为 99.0%和 84.5%。APAS 可检测到 99.0%的血琼脂平板和 99.5%的 MacConkey 琼脂平板上的生长菌落。DPR 与 TPR 在 92.1%的平板上对菌落计数的结果一致，其对病例指定的灵敏度为 90.8%，特异性为 92.8%。然而，在使用 DPR 对菌落形态进行分类时，发现了一些差异。
APAS 被证明是一种可靠的尿液培养物筛选系统。该研究还表明，DPR 与 TPR 在菌落检测、计数和病例指定方面具有可接受的一致性。
