Vildan AVKAN OĞUZ, Nurbanu SEZAK, Aygün ÖZTOP, Ayşe YÜCE, Süheyla SÜRÜCÜOĞLU, Nur YAPAR

A comparison of two diff erent fl uorochrome stains for the detection of acid-fast bacilli in sputum specimens

Amaç: Aktif tüberkülozun erken tanısı hala balgam yaymalarında aside dirençli basil varlığına bağlıdır. Bu çalışmada amacımız iki farklı fl orokrom boyama yönteminin maliyetini ve etkinliğini araştırmaktır. Yöntem ve gereç: 642 hastadan 1013 balgam örneği toplandı. Her örnekten üçer yayma preparat ve kültür yapıldı. Laboratuvar yöntemleri çift kör ve prospektif olarak uygulandı. Yayma preparatlar, ticari Auramine/Acridine Orange kit (Boya1), manuel olarak hazırlanan Auramine- Rhodamine/KMnO4 (Boya 2) and Ziehl-Neelsen stain (EZN) boyaları ile boyandı. Bulgular: 1013 balgam örneğinin 101’i kültür pozitift i. Kültür pozitifl erin 60’ında EZN, 53’ünde Boya1 ve 81’inde Boya2 ile aside dirençli basil saptandı. Kültüre göre boya1 ve boya2 nin duyarlılık ve özgüllükleri sırasıyla % 52,4, % 94,6 ve % 80,1, % 83,8 dir. Boyama yöntemlerinin maliyetleri arasında istatistiksel anlamlı fark saptanmadı.Sonuç: Boya1’in duyarlılığı Boya2’den daha düşük fakat daha kolay uygulanabilir ve ucuzdur. Bununla birlikte Boya2’nin hazırlık dönemi daha uzun zaman gerektirir, iş gücü fazladır ve kansorejen madde ile maruziyet riski daha fazladır. Boya1’in duyarlılığını arttırmak için içeriğinin yeniden gözden geçirilmesi önerilir. Tüberküloz tanısında yeniden düzenlenen kit içeriği pratik kullanım sağlayacaktır

Balgam örneklerinde aside dirençli basil saptanması için iki farklı florokrom boyanın karşılaştırılması

Aim: Th e early diagnosis of active tuberculosis still depends on the presence of acid-fast bacilli (AFB) in stained sputum smears. In this study, our aim was to investigate the effi ciency and cost-eff ectiveness of two diff erent fl uorochrome stains. Materials and methods: A total of 1013 sputum specimens were collected from 642 patients. Th ree smears and cultures were prepared from each specimen. Double-blind and prospective laboratory procedures were performed. Slides were stained with a commercial auramine/acridine orange kit (Stain 1), an in-house preparation of auramine- rhodamine/ KMnO4 (Stain 2) and a Ziehl-Neelsen stain (EZN). Results: Of the 1013 specimens, 101 were culture positive. Among these, AFB was detected in 60 specimens by EZN, in 53 by Stain 1, in 81 by Stain 2. By cultures, the sensitivities and specifi cities of Stain 2 were 80.1% and 83.8%, respectively, and for Stain 1, 52.4% and 94.6% respectively. Th ere is no signifi cant diff erence between the costs of these methods. Conclusion: Stain 1 was easy to apply and inexpensive but the sensitivity of Stain 1 was lower than that of Stain 2. However, Stain 2 required longer preparation time, more work, and had a higher risk of exposure to carcinogens. In order to increase the sensitivity of Stain 1, it is suggested that the contents of the prepared Stain 1 kit could be rearranged. In tuberculosis diagnosis, this revised kit may provide practicality in use.

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