Clinical value of auramine O fluorescence staining automatic microscopic scanning and recognition system for detecting tuberculosis

doi:10.19982/j.issn.1000-6621.20250412

Abstract

Abstract:

Objective：To evaluate the application value of a fully automatic auramine O fluorescence staining microscopic scanning system （OF-AS，software recognition） in tuberculosis diagnosis. Methods：A total of 503 consecutive patients with suspected pulmonary tuberculosis who visited the outpatient department of Tianjin Tuberculosis Control Center for the first time from January to August 2025 were enrolled. Three initial sputum specimens were collected from each patient，with a total of 1509 specimens which all were subjected to auramine O fluorescence staining，and then microscopic examination was performed with double-blinded method using traditional manual microscopy （abbreviated as “manual microscopy”） and OF-AS respectively. One sputum specimen of good quality was selected from each patient for BACTEC MGIT 960 mycobacterial liquid culture （abbreviated as “MGIT 960 culture”），with a total of 503 cases completed. Taking MGIT 960 culture as the gold standard for the detection of pulmonary tuberculosis，the efficacies of manual microscopy and OF-AS in testing sputum specimens from patients with pulmonary tuberculosis were analyzed；rank correlation of positive results detected by both manual microscopy and OF-AS was analyzed. Results：The positive rate of manual microscopy （12.39%，187/1509） was higher than that of OF-AS （11.73%，177/1509），but the difference was not statistically significant （χ²=0.576，P>0.05）. Using MGIT 960 culture as the reference standard，the sensitivity and specificity of OF-AS for detecting tuberculosis were 51.76% （103/199） and 95.39% （290/304），respectively，which were slightly lower than those of manual microscopy （sensitivity：52.43%，108/206；specificity：96.97%，288/297）. Both diagnostic methods showed moderate agreement with the gold standard （Kappa values：0.529 and 0.508，respectively）. A total of 54 sputum smears had discordant results between OF-AS and manual microscopy，mainly due to missed detection by the scanner and interference from staining sediment. Eight sputum smears showed discordance between initial manual microscopy and repeated manual microscopy，all attributed to missed detection under microscopy. Conclusion：OF-AS （software recognition） has good application value in testing sputum specimens of suspected pulmonary tuberculosis patients，and its detection performance can meet the requirements of implementing traditional auramine O staining project for detecting mycobacterium.

Key words: Mycobacterium tuberculosis, Microscopy, fluorescence, Diagnosis, differential

CLC Number:

Jiang Lina, Dai Wenxi, Ju Hanfang, Meng Sukai, Wang Chunhua. Clinical value of auramine O fluorescence staining automatic microscopic scanning and recognition system for detecting tuberculosis[J]. Chinese Journal of Antituberculosis, 2026, 48(4): 504-509. doi: 10.19982/j.issn.1000-6621.20250412

Figures/Tables 4

References 17

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人工复核	人工镜检						合计
人工复核	N条	+	++	+++	++++	阴性	合计
N条	6	8	0	0	0	6	20
+	22	54	0	0	0	2	78
++	2	3	46	0	0	0	51
+++	0	0	6	17	0	0	23
++++	0	0	0	0	23	0	23
阴性	0	0	0	0	0	1314	1314
合计	30	65	52	17	23	1322	1509

检查方法	MGIT 960培养（份）		敏感度（%，95%CI）	特异度（%，95%CI）	阳性预测值（%，95%CI）	阴性预测值（%，95%CI）	AUC值	Kappa值
检查方法	阳性	阴性	敏感度（%，95%CI）	特异度（%，95%CI）	阳性预测值（%，95%CI）	阴性预测值（%，95%CI）	AUC值	Kappa值
人工镜检			52.43 （70.45~79.42）	96.97 （94.13~98.51）	92.31 （85.50~96.20）	74.61 （69.91~78.82）	0.757	0.529
阳性	108	9
阴性	98	288
OF-AS			51.76 （44.60~58.85）	95.39 （92.22~93.06）	88.03 （80.42~93.06）	75.13 （70.45~79.30）	0.736	0.508
阳性	103	14
阴性	96	290