Document Detail

Hydrochloric vs. sulphuric acid in water for Ziehl-Neelsen staining of acid-fast bacilli.
MedLine Citation:
PMID:  21682971     Owner:  NLM     Status:  In-Data-Review    
SETTING: Damien Foundation Bangladesh tuberculosis (TB) control projects.
OBJECTIVES: To compare 25% sulphuric acid in water (H(2)SO(4)) with hydrochloric acid in water (HCl) to differentiate acid-fast bacilli in sputum smears stained with 1% carbolfuchsin.
DESIGN: For 1 year, all 158 microscopy laboratories used either H(2)SO(4) or 3%/6%/10% HCl for their routine work, alternating monthly between H(2)SO(4) and HCl. Each month a sample of five smears per laboratory was rechecked blind. After recording qualitative staining aspects, all sample smears were restained before rechecking, using H(2)SO(4) for destaining.
RESULTS: A total of 368 059 H(2)SO(4) and 335 436 HCl smears were routinely read, yielding 7.2% positive or scanty results in both groups. Of these, 9492 were rechecked. There was no difference in false-negatives detected (0.66%, 95%CI 0.44-0.95 for H(2)SO(4) vs. 0.68%, 95%CI 0.46-0.98 for HCl), but apparently there were more false-positives with H(2)SO(4) (2.12%, 95%CI 0.92-4.14 vs. 0.28%, 95%CI 0.00-1.54, P = 0.05). Qualitatively, only 3% HCl yielded significantly inferior differentiation results.
CONCLUSIONS: HCl 6-10% in water can be recommended for Ziehl-Neelsen destaining above H(2)SO(4). Diluting is easier and safer, and it may cause less confusion with false-positives during rechecking, including a restaining step.
K J M Aung; P Nandi; A Hamid Salim; A Hossain; A Van Deun
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease     Volume:  15     ISSN:  1815-7920     ISO Abbreviation:  Int. J. Tuberc. Lung Dis.     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706389     Medline TA:  Int J Tuberc Lung Dis     Country:  France    
Other Details:
Languages:  eng     Pagination:  955-8     Citation Subset:  IM    
Damien Foundation Bangladesh, Dhaka, Bangladesh.
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