Microscopy as a diagnostic tool in pulmonary tuberculosis
Ritu Singhal1, Vithal Prasad Myneedu1
1National Reference Laboratory & WHO Center of Excellence (Tuberculosis), Department of Microbiology, National Institute of Tuberculosis & Respiratory Diseases (NITRD), India.
International Journal of Mycobacteriology
|December 15, 2015
Summary
Tuberculosis detection relies on microscopy, a cost-effective method. Enhancements like LED fluorescence microscopy show promise for improving tuberculosis case detection sensitivity and accuracy.
Area of Science:
- Medical microbiology
- Infectious diseases
- Public health
Background:
- Tuberculosis (TB) remains a significant global health challenge, particularly in developing nations, due to high incidence and mortality rates.
- Microscopy is a cornerstone of TB case detection, valued for its affordability, speed, simplicity, and high specificity.
Purpose of the Study:
- To review modifications aimed at enhancing the sensitivity of microscopy for tuberculosis detection.
- To identify the most promising alternative methods to traditional Ziehl-Neelsen (ZN) staining for improved TB diagnosis.
Main Methods:
- Review of various concentration methods for improving sputum sample analysis, including centrifugation and chemical treatments (N-acetyl cysteine-sodium hydroxide, bleach, ammonium sulfate, chitin).
- Evaluation of modifications to Ziehl-Neelsen (ZN) staining, such as altered carbol fuchsin concentrations and alternative staining techniques like Kinyoun staining.
- Assessment of advanced imaging techniques, including fluorescent microscopy and immune-fluorescence, with a focus on light-emitting diode (LED) fluorescence microscopy.
Main Results:
- Several concentration methods have been explored to increase the yield of Mycobacterium tuberculosis from patient samples.
- Modifications to classical Ziehl-Neelsen (ZN) staining and alternative staining methods have been investigated to improve diagnostic performance.
- Light-emitting diode (LED) fluorescence microscopy is identified as a highly plausible and effective alternative to conventional ZN staining for TB detection.
Conclusions:
- While traditional microscopy remains essential for tuberculosis diagnosis, its sensitivity can be limited.
- Various pre-analytical and analytical modifications can enhance the diagnostic accuracy of microscopy.
- LED fluorescence microscopy emerges as a leading alternative, offering improved sensitivity and potentially wider applicability for tuberculosis case detection.
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