Ba F, Rieder H L
Laboratoire National de Référence pour la Tuberculose, Programme National de lutte contre la Tuberculose, Dakar, Senegal.
Int J Tuberc Lung Dis. 1999 Dec;3(12):1101-5.
National Tuberculosis Reference Laboratory in Dakar, Senegal.
Comparison of results with fluorescence and bright-field microscopy for acid-fast bacilli.
Two smears from 2,630 consecutive sputum specimens between January 1996 and June 1998 were prepared for blinded examination of one smear each by the Ziehl-Neelsen technique and fluorescence microscopy at 1,000x magnification. The time required to declare a slide as negative was determined for both techniques in a sample of 68 slides.
Concordancewas 96.9% and 92.3% for diagnostic and follow-up examinations, respectively. The yield was similar with both techniques for specimens with at least 10 bacilli per 100 fields, but higher with fluorescence microscopy in those with fewer than 10 bacilli per 100 fields. The mean time required by fluorescence microscopy before declaring a slide as negative with the same magnification was 3 minutes 34 seconds, compared to 7 minutes 44 seconds with the Ziehl-Neelsen technique.
The results obtained with one technique are highly reproducible by the other. Fluorescence microscopy appears to be more likely to detect bacilli in paucibacillary cases than bright-field microscopy, and it more than halves the required examination time.
塞内加尔达喀尔的国家结核病参考实验室。
比较抗酸杆菌荧光显微镜检查和明视野显微镜检查的结果。
1996年1月至1998年6月间连续收集的2630份痰标本制成两张涂片，分别用萋 - 尼氏技术和荧光显微镜在1000倍放大倍数下进行盲法检查。在68张涂片样本中确定两种技术将涂片判定为阴性所需的时间。
诊断性检查和随访检查的一致性分别为96.9%和92.3%。对于每100个视野中至少有10条杆菌的标本，两种技术的检出率相似，但对于每100个视野中杆菌少于10条的标本，荧光显微镜检查的检出率更高。在相同放大倍数下，荧光显微镜判定涂片为阴性所需的平均时间为3分34秒，而萋 - 尼氏技术为7分44秒。
一种技术获得的结果用另一种技术高度可重复。荧光显微镜检查在少菌型病例中似乎比明视野显微镜检查更有可能检测到杆菌，并且所需检查时间减少一半以上。
