Department of Laboratory, Beijing Jishuitan Hospital, Beijing, China.
Peking University Fourth School of Clinical Medicine, Beijing, China.
Scand J Clin Lab Invest. 2022 Sep;82(5):385-390. doi: 10.1080/00365513.2022.2100273. Epub 2022 Jul 19.
To investigate the diagnostic performance and clinical value of flow microimaging and artificial intelligence recognition technology for rapid screening of suspected urinary tract infection (UTI). Standard strains of bacteria responsible for UTIs, ATCC25922 and ATCC25923 were prepared and used to evaluate the accuracy of classifying and counting bacteria. A total of 146 specimens of clean, midstream urine were collected from adults with suspected UTI (excluding pregnant women, and patients with urethral catheterization) and analyzed by urinary culture and assay using a MUS-3600 analyzer. Fourfold tables were used to evaluate the diagnostic performance in measurements of nitrite and leukocyte esterase. ROC curves were generated to identify cutoff values for bacillus, coccus, leukocyte, and leukocyte cluster counts. Of the samples cultured, 85 (58%) were negative and 61 (42%) were positive. and showed good linear relationships between measured and theoretical values in a series of standard strains samples (>0.95). The sensitivity of the nitrite parameter for diagnosis of suspected UTI was 37.7% and the specificity was 100%. Cutoff values obtained from ROC analysis were 50 μl for bacillus (sensitivity: 69.5%; specificity: 96.5%) with positive predictive value of 93.2% and negative predictive value of 82%. WBC ≥ 23 μl or bacillus ≥50 μl gave the highest sensitivity of 81% and NPV of 86%. MUS-3600 demonstrated sufficient specificity for UTIs to have utility in reducing needless urinary culture. Accuracy in classifying bacillus shows great potential for the rapid identification of pathogens for clinical purposes.
为了研究流动微成像和人工智能识别技术在快速筛选疑似尿路感染（UTI）方面的诊断性能和临床价值。我们准备了引起 UTI 的标准菌株 ATCC25922 和 ATCC25923，用于评估分类和计数细菌的准确性。共收集了 146 例成人疑似 UTI（不包括孕妇和尿道插管患者）的清洁中段尿标本，采用尿液培养和 MUS-3600 分析仪进行检测。采用四格表评估亚硝酸盐和白细胞酯酶检测的诊断性能。绘制 ROC 曲线确定杆菌、球菌、白细胞和白细胞簇计数的截断值。培养的标本中，85 例（58%）为阴性，61 例（42%）为阳性。在一系列标准菌株样本中，和显示了测量值与理论值之间良好的线性关系（>0.95）。亚硝酸盐参数诊断疑似 UTI 的敏感性为 37.7%，特异性为 100%。ROC 分析得出的截断值为杆菌 50μl（敏感性：69.5%；特异性：96.5%），阳性预测值为 93.2%，阴性预测值为 82%。白细胞≥23μl 或杆菌≥50μl 的敏感性最高为 81%，NPV 为 86%。MUS-3600 对 UTI 具有足够的特异性，可用于减少不必要的尿液培养。分类杆菌的准确性具有很大的潜力，可用于临床快速识别病原体。
