Ulukanligil M, Aslan G, Tasçi S
Department of Microbiology, Harran University Medical School, Sanliurfa, Turkey.
Mem Inst Oswaldo Cruz. 2000 Nov-Dec;95(6):855-8. doi: 10.1590/s0074-02762000000600019.
The presence of acid fast bacilli in multiple specimens was investigated comparatively with Ziehl-Neelsen (ZN) and fluorescence microscopy (FM) staining in order to determine sensitivity in detecting tuberculosis (TB). A total of 465 specimens obtained from 295 patients were analysed at Harran University Medical School Hospital between March 1998 and March 2000. The culture was employed as the reference method. Sixty-eight patients (23.1%) were diagnosed as having TB by culture. The ZN and FM staining sensitivities were 67.6% (46/68) and 85.2% (58/68) respectively. Two hundred and one patients (68.1%) submitted one specimen to the laboratory. TB positivity was detected in 42 (20.9%) of these patients by culture. The sensitivities of ZN and FM stains were found to be 61% and 83% in these patients. However, in 18 patients (6.1%) who submitted two specimens to the laboratory, the TB was positive in six of them (33.3%) and ZN and FM sensitivities were 66% and 83% respectively. When three specimens or more were collected from the patients (76 patients, 25.8%), TB positivity was determined in 20 of them (26.3%) and the sensitivities were 80% and 92% in the ZN- and FM-stained smears, respectively. Our data indicate that in the diagnosis of TB, FM has greater sensitivity than ZN. In particular, in the case of a single specimen, the diagnostic value of FM is quite significant. It is, therefore, possible to conclude that both ZN and FM staining can be used for the diagnosis of TB when there are more than two specimens. However, if only one or two specimens are available, FM staining is preferable.
为了确定检测结核病（TB）的敏感性，对多个标本中抗酸杆菌的存在情况，采用萋-尼（ZN）染色法和荧光显微镜（FM）染色法进行了比较研究。1998年3月至2000年3月期间，对哈兰大学医学院医院从295名患者身上获取的465份标本进行了分析。培养法用作参考方法。68名患者（23.1%）经培养确诊患有结核病。ZN染色法和FM染色法的敏感性分别为67.6%（46/68）和85.2%（58/68）。201名患者（68.1%）向实验室提交了一份标本。通过培养在这些患者中的42名（20.9%）检测到结核阳性。在这些患者中，ZN染色法和FM染色法的敏感性分别为61%和83%。然而，在向实验室提交两份标本的18名患者（6.1%）中，其中6名（33.3%）结核呈阳性，ZN染色法和FM染色法的敏感性分别为66%和83%。当从患者身上采集三份或更多标本时（76名患者, 25.8%），其中20名（26.3%）检测到结核阳性，ZN染色涂片和FM染色涂片的敏感性分别为80%和92%。我们的数据表明，在结核病诊断中，FM比ZN具有更高的敏感性。特别是在单个标本的情况下，FM的诊断价值相当显著。因此，可以得出结论，当有两份以上标本时，ZN染色法和FM染色法均可用于结核病的诊断。然而，如果只有一份或两份标本，FM染色法更可取。
