{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:39:53Z","timestamp":1792676393106,"version":"4.5.0"},"reference-count":33,"publisher":"American Society for Microbiology","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Jiangxi Provincial Health Commission Science and Technology Plan","award":["202311367"],"award-info":[{"award-number":["202311367"]}]},{"name":"Seed Fund of No. 908th Hospital of Chinese PLA Joint Logistic Support Force","award":["2022YNKT006"],"award-info":[{"award-number":["2022YNKT006"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Current latent tuberculosis infection (LTBI) screening is limited by tuberculin skin test (TST) cross-reactivity, return-visit requirements, and interferon-gamma release assay (IGRA) costs. We developed a flow cytometry and deep learning CD161 immunoscore screening method, evaluating it across two phases (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 269) in Jiangxi, China. Phase 1 (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 110; 92 males, 18 females) used healthy controls (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 88) and clinically cured, post-treatment tuberculosis (TB) patients (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 22) for model development. This post-treatment cohort served as a proxy and was not equivalent to untreated LTBI. Phase 2 (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 159, all males) provided an independent, three-site proof-of-concept evaluation against TST, using IGRA as the reference standard. In phase 1, the optimal model achieved 100% sensitivity and 92% specificity. In phase 2, using a non-independently validated, post hoc Youden-selected cutoff (60.57), the immunoscore demonstrated 81.8% sensitivity, 80.4% specificity, and an area under the receiver operating characteristic curve (AUC) of 0.833. This performance was comparable to TST (90.9% sensitivity, 72.3% specificity, AUC = 0.816, and DeLong\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.701). The immunoscore showed significantly higher specificity than TST (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.049) but similar sensitivity (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.521), with an IDI of 0.077 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.021) and good calibration (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.553). These exploratory, all-male results do not establish discrimination between untreated LTBI, post-treatment sensitization, or active TB, necessitating diverse validation.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>A machine-learning-driven CD161 immunoscore using flow cytometry provides rapid latent tuberculosis infection (LTBI) screening with diagnostic performance comparable to established methods. Across this two-phase study of 269 participants, the independent all-male phase 2 cohort of 159 participants yielded a sensitivity of 81.8% and a specificity of 80.4% for the CD161 immunoscore. Performance remained consistent across colleges with sevenfold variation in LTBI prevalence (1.8%\u201312.2%), supporting robustness. For congregate settings such as colleges, this laboratory-based approach may offer operational advantages by providing same-day initial screening without requiring a return visit for result interpretation. A possible future application would be a staged pathway in which immunoscore-positive individuals undergo confirmatory interferon-gamma release assay testing. This implementation strategy remains conceptual and requires prospective evaluation of referral rates, laboratory capacity, acceptability, clinical outcomes, and cost-effectiveness. These proof-of-concept findings require confirmation in larger external cohorts with adequate female representation and more diverse demographic, occupational, and geographic backgrounds.<\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.01118-26","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:03:22Z","timestamp":1792674202000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Development and preliminary validation of a CD161 immunoscore-based screening method for latent tuberculosis infection in a Chinese training cohort"],"prefix":"10.1128","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5520-0843","authenticated-orcid":false,"given":"Yuanyuan","family":"Xiong","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory and Blood Transfusion, No. 908th Hospital of Chinese PLA Joint Logistic Support Force","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Huang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/037p24858","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Medical Information, No. 908th Hospital of Chinese PLA Joint Logistic Support Force","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory and Blood Transfusion, No. 908th Hospital of Chinese PLA Joint Logistic Support Force","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Patient Management, No. 908th Hospital of Chinese PLA Joint Logistic Support Force","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Shuang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, No. 908th Hospital of Chinese PLA Joint Logistic Support Force","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of the Second Outpatient Department, No. 908th Hospital of Chinese PLA Joint Logistic Support Force","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory and Blood Transfusion, No. 908th Hospital of Chinese PLA Joint Logistic Support Force","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory and Blood Transfusion, No. 908th Hospital of Chinese PLA Joint Logistic Support Force","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4225-1165","authenticated-orcid":true,"given":"Yu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory and Blood Transfusion, No. 908th Hospital of Chinese PLA Joint Logistic Support Force","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"WHO. 2024. 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