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Equivalence of acid alone or acid-alcohol as decolourizing agent in Ziehl-Neelsen method
M Gomathi Sekar1, Fathima Rehman, Vanaja Kumar
1Department of Bacteriology (Retd), National Institute for Research in Tuberculosis (ICMR), Chetput, Chennai - 600 031, Tamil Nadu.
Background:
Microscopists opine that acid-alcohol decolourized slides may enhance acid-fast bacilli (AFB) smear positivity, and published documents on equivalence of acid and acid-alcohol in ZN staining method are not easily accessible.
Setting:
National Institute for Research in Tuberculosis, Chennai, India.
Objective:
To document the equivalence of 25% sulphuric acid (ZN-acid method) and 3% hydrochloric acid-alcohol (ZN-alcohol method) as decolourizing agents in ZN method for detection of acid-fast bacilli.
Methods:
Two smears from each of 253 sputum samples from pulmonary tuberculosis patients, prepared and allocated, one to ZN-acid method and another to ZN-alcohol method were read blind. All the specimens were cultured for Mycobacterium tuberculosis by modified Petroff's method. Culture of M. tuberculosis was gold standard.
Results:
The concordance between the methods was 85% (kappa 0.68), and the sensitivity (79%) and specificity (89%) were same for both the methods.
Conclusion:
In conclusion, the common belief that acid-alcohol decolourized slides give enhanced smear positivity stands void.
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