Inefficiency of 0.3% Carbol Fuchsin in Ziehl-Neelsen Staining for Detecting Acid-Fast Bacilli

Author:

Selvakumar N.1,Rahman Fathima1,Rajasekaran S.2,Narayanan P. R.1,Frieden Thomas R.3

Affiliation:

1. Tuberculosis Research Centre, Indian Council of Medical Research, Chennai, 600 031 Tamil Nadu

2. Government Hospital for Thoracic Medicine, Tambaram Sanatorium, Chennai, 600 047 Tamil Nadu

3. South-East Asia Regional Office, World Health Organization, New Delhi, India

Abstract

ABSTRACT We compared the sensitivity and specificity of a modified Ziehl-Neelsen (modified-ZN) staining method for acid-fast bacilli (AFB) with that of the standard Ziehl-Neelsen (standard-ZN) staining method, using culture results with Mycobacterium tuberculosis as the “gold standard.” The sensitivity (72%; 101 of 140) of the modified-ZN staining method, which uses 0.3% carbol fuchsin, was significantly lower than that of the standard-ZN staining method (84%; 117 of 140); the modified-ZN method missed 21% of cases detected by the standard-ZN method and 11% more of culture-positive samples than the standard-ZN method. The World Health Organization recommendation of 0.3% carbol fuchsin in the ZN method for staining AFB needs to be reconsidered.

Publisher

American Society for Microbiology

Subject

Microbiology (medical)

Reference12 articles.

1. Anderson, G., and A. J. Coup. 1975. Effect of decalcifying agents on the staining of Mycobacterium tuberculosis. J. Clin. Pathol.28:744-745.

2. Central TB Division Directorate General of Health Services Ministry of Health and Family Welfare. 1998. Revised National Tuberculosis Control Programme manual for laboratory technicians. Ministry of Health and Family Welfare New Delhi India. [Online.] http://www.tbcindia.org/LABMANUAL.pdf .

3. Fodor, T. 1984. Bulk staining of sputum by the Ziehl-Neelsen method. Tubercle65:123-125.

4. Hafiz S. R. C. Spencer M. Lee H. Gooch and B. I. Duerden. 1984. Rapid Ziehl-Neelsen staining by use of microwave oven. Lancet ii: 1046.

5. Karin, W. 1998. Laboratory services in tuberculosis control. Part II. Microscopy. WHO Tech. Bull.98:258.

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