Van Deun A, Hamid Salim A, Aung K J M, Hossain Md A, Chambugonj N, Hye Md A, Kawria A, Declercq E
Mycobacteriology Unit, Institute of Tropical Medicine, Antwerpen, Belgium.
Int J Tuberc Lung Dis. 2005 Oct;9(10):1127-33.
A field project in Bangladesh.
To compare the effectiveness of commonly used carbolfuchsin staining variations.
Routine hot Ziehl-Neelsen (ZN) 1% basic fuchsin staining for 15 min in 75 field clinics. Blind reading of duplicate smears stained by ZN 1% vs. 0.3% basic fuchsin applied for 5 min, or by ZN 1% 5 min vs. Kinyoun cold staining. Rechecking of discordant series.
For comparable numbers of false positives, sensitivity was significantly lower with Kinyoun than with ZN 1% 5 min (85.6% vs. 93.0%, P < 0.001). Sensitivity with ZN 1% 5 min was not significantly higher than with 0.3% 5 min staining (89.9% vs. 86.5%). Routine examination using 1% 15 min ZN identified more positives than any of the study techniques.
Kinyoun cold staining sensitivity was unsatisfactory in field clinics. The sensitivity of the WHO/IUATLD recommended 0.3% fuchsin for 5 min was not significantly different from the original 1% ZN for 5 min, but 1% 15 min hot staining might be superior. A reduced fuchsin concentration together with a short staining time may leave too narrow a margin for error. TB programmes using hot ZN with a concentrated stain or longer staining time should not be urged to change.
孟加拉国的一项实地项目。
比较常用的石炭酸复红染色方法的有效性。
在75个现场诊所采用常规热齐-尼氏（ZN）1%碱性复红染色15分钟。对用ZN 1%与0.3%碱性复红染色5分钟的重复涂片进行盲法读片，或对ZN 1%染色5分钟与金扬冷染色的涂片进行盲法读片。对不一致的系列进行复查。
在假阳性数量相当的情况下，金扬染色的敏感度显著低于ZN 1%染色5分钟（85.6%对93.0%，P<0.001）。ZN 1%染色5分钟的敏感度与0.3%染色5分钟相比无显著差异（89.9%对86.5%）。使用1% ZN染色15分钟的常规检查发现的阳性病例比任何一种研究技术都多。
在现场诊所，金扬冷染色的敏感度不令人满意。世界卫生组织/国际防痨和肺部疾病联盟推荐的0.3%复红染色5分钟的敏感度与原来的1% ZN染色5分钟无显著差异，但1%染色15分钟的热染色可能更优。复红浓度降低且染色时间缩短可能会使误差范围过窄。不应敦促使用浓染剂或较长染色时间的热ZN染色的结核病防治项目进行更改。
