发光二极管显微镜盲法复查抗酸杆菌涂片。
Blinded rechecking of acid-fast bacilli smears by light-emitting diode microscopy.
机构信息
Department of Mycobacteriology, National Institute for Research in Tuberculosis, Chetput, Chennai, India.
出版信息
Int J Tuberc Lung Dis. 2013 Sep;17(9):1220-3. doi: 10.5588/ijtld.12.0881.
BACKGROUND
Blinded rechecking of auramine-stained acid-fast bacilli (AFB) sputum smears using fluorescence microscopy (FM), especially FM using light-emitting diode (LED), is not well understood.
OBJECTIVE
To examine the rechecking of auramine-stained sputum smears without restaining within a month using LED FM.
METHODS
A total of 4799 centrifuged smears of sputum samples were stained by the auramine phenol method and examined using LED FM; 564 systematically selected smears were subjected to blinded rechecking without restaining by controllers. The initial results of the readers were compared to those of the controllers. Discrepancies were resolved by a referee. The quality of LED FM was assessed by the referee using the culture result as gold standard.
RESULTS
Among the rechecked smears, one high false-negative error was made by a reader, while one high false-positive error and 19 high false-negative errors were made by the controllers. The errors were resolved by culture. Smear results for 18 slides were not available due to AFB fading.
CONCLUSION
AFB colour fading using LED FM, which affected the accurate evaluation of blinded rechecking of AFB smears without restaining within a month, is confirmed in this large study.
背景
使用荧光显微镜（FM），特别是使用发光二极管（LED）对金胺染色的抗酸杆菌（AFB）痰涂片进行盲法复查，目前尚未得到很好的理解。
目的
检查在一个月内不重新染色的情况下使用 LED FM 对金胺染色的痰涂片进行复查。
方法
对 4799 份离心痰标本进行金胺苯酚染色，使用 LED FM 进行检查；564 份系统选择的涂片由对照者进行不重新染色的盲法复查。读者的初始结果与对照者的结果进行比较。由裁判解决差异。裁判使用培养结果作为金标准评估 LED FM 的质量。
结果
在复查的涂片中有一个高假阴性错误是由一个读者造成的，而对照者则出现了一个高假阳性错误和 19 个高假阴性错误。通过培养解决了这些错误。由于 AFB 褪色，18 张涂片的涂片结果不可用。
结论
在这项大型研究中证实，AFB 颜色褪色会影响对一个月内不重新染色的 AFB 涂片盲法复查的准确评估，这种情况在使用 LED FM 时尤为明显。
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