Share This Article:

Evaluation of Increased Sensitivity of Morning Bleach Sample for Detection of Acid Fast Bacilli in Pulmonary Samples

Abstract Full-Text HTML Download Download as PDF (Size:2497KB) PP. 119-124
DOI: 10.4236/jtr.2014.23015    2,611 Downloads   3,127 Views   Citations

ABSTRACT

Around 85% of the cases of Tuberculosis (TB) are pulmonary in origin and the routine diagnosis usually depends on sputum microscopy. The conventional direct Ziehl-Nelson (ZN) staining technique has been found to have a low sensitivity. The main objective of the study was to verify whether the bleach concentration method increases the sensitivity of sputum smear microscopy for AFB or not and also to see whether the first single morning sample alone is sufficient and better than the three pooled samples after bleach concentration followed by ZN staining. A total of 365 samples were studied from 131 clinically suspected cases of pulmonary TB which included sputum (112), gastric aspirate (5), endotracheal tube washing (2), and bronchial lavage (12). All these samples were processed for conventional ZN staining and Bleach concentration method followed by ZN staining. An increase in positivity was observed in all the cases after using the bleach concentration method and the most significantly useful was that in the case of first morning sputum samples where it increased from 11.6% to 41.96%. Bleach concentration is a simple, cheap and easily available method and also very safe because it kills the Mycobacteria in the process. Its positivity rate is better as compared to direct conventional ZN staining.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Pingle, P. , Apte, P. and Trivedi, R. (2014) Evaluation of Increased Sensitivity of Morning Bleach Sample for Detection of Acid Fast Bacilli in Pulmonary Samples. Journal of Tuberculosis Research, 2, 119-124. doi: 10.4236/jtr.2014.23015.

References

[1] WHO (2011) The Sixteenth Global Report on Tuberculosis. WHO, Geneva.
[2] Githui, W.A., Matu, S.W., Muthmi, L.N. and Juma, E. (2007) Improved Diagnosis of Ziehl Neelsen Smear Negative Tuberculosis Using Sodium Hypochlorite Sedimentation Method. East African Medical Journal, 84, 455-459.
[3] WHO (2012) Global Tuberculosis Report. WHO, Geneva.
[4] TB India (2012) Revised National TB Control Programme, Annual Status Report. Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, NirmanBhawan, New Delhi.
[5] Rahbar, M. and Hajia, M. (2007) Value of Gastric Lavage for Diagnosis of Pulmonary Tuberculosis. Pakistan Journal of Medical Sciences, 23, 51-53.
[6] Angeby, K. (2004) Tuberculosis. Diagnosis and Drug Susceptibility Testing Where Resources Are Scarce. Karolinska University Press, Stockholm.
[7] Cattamanchi, A., Davis, J.L., Pai, M., Huang, L., Hopewell, P.C. and Steingert, K.R. (2010) Does Bleach Processing Increase the Accuracy of Sputum Smear Microscopy for Diagnosing Pulmonary Tuberculosis? Journal of Clinical Microbiology, 48, 2433-2439. http://dx.doi.org/10.1128/JCM.00208-10
[8] Gebre, N.U., Karlsson, G., Jonsson, R., et al. (1995) Improved Microscopical Diagnosis of Pulmonary Tuberculosis in Developing Countries. Transactions of the Royal Society of Tropical Medicine and Hygiene, 89, 191-193. http://dx.doi.org/10.1016/0035-9203(95)90491-3
[9] Mutha, A., Tiwari, S., Khubnanai, H. and Mall, S. (2005) Application of Bleach Method to Improve Sputum Smear Microscopy for the Diagnosis of Pulmonary Tuberculosis. Indian Journal of Pathology and Microbiology, 48, 513- 517.
[10] Steingert, K.R., Ng, V., Henry, M., et al. (2006) Sputum Processing Methods to Improve the Sensitivity of Smear Microscopy for Tuberculosis: A Systemic Review. The Lancet Infectious Diseases, 6, 664-674. http://dx.doi.org/10.1016/S1473-3099(06)70602-8
[11] Angaw, B., Mulu, A., Abate, E., Belay, T., et al. (2012) Improved Detection of Acid Fast Bacilli in Sputum by Bleach- Concentration Technique at Gondar University Teaching Hospital, Northwest Ethiopia. Ethiopian Medical Journal, 50, 349-354.
[12] Makunde, W.H., Makunde, R.A., Kamugisha, L.M., Mgema, S.G. and Liwa, A. (2007) Improved Microscopy Diagnosis of Pulmonary Tuberculosis Using Sodium Hypochlorite Concentration Technique in Tanga, Tanzania. Tanzania Health Research Bulletin, 9, 87-93. http://dx.doi.org/10.4314/thrb.v9i2.14309
[13] Merid, Y., Yassin, M.A., Yamuah, L., Kumar, R., Engers, H. and Aseffa, A. (2009) Validation of Bleach-Treated Smears for the Diagnosis of Pulmonary Tuberculosis. The International Journal of Tuberculosis and Lung Disease, 13, 136-141.
[14] Mase, S.R., Ramsay, A., Ng, V., et al. (2007) Yield of Serial Sputum Examinations in the Diagnosis of Pulmonary Tuberculosis: A Systematic Review. The International Journal of Tuberculosis and Lung Disease, 11, 485-495.
[15] Padma, S., Kamesh, S. and Daley, P. (2009) Bleach Optimization of Sputum Smear Microscopy for Pulmonary Tuberculosis. Indian Journal of Tuberculosis, 56, 174.
[16] Pandey, A. and Asthana, A.K. (2009) Sedimentation Method, a Good Alternative to Centrifugation for Concentration of AFB in Developing Countries. Indian Journal of Medical Microbiology, 27, 83-84.
[17] Best, M., Sattar, S.A., Springthorpe, V.S. and Kennedy, M.E. (1990) Efficacies of Selected Disinfectants against Mycobacterium tuberculosis. Journal of Clinical Microbiology, 28, 2234-2239.
[18] Kent, P.T. and Kubica, G.P. (1985) Public Health Mycobacteriology: A Guide for the Level III Laboratory. Centers for Disease Control, Atlanta.
[19] Lawson, L., Yassin, M.A., Ramsay, A., Olajide, I., Thacher, T.D., Davies, P.D., Squire, S.B. and Cuevas, L.E. (2006) Microbiological Validation of Smear Microscopy after Sputum Digestion with Bleach; A Step Closer to a One-Stop Diagnosis of Pulmonary Tuberculosis. Tuberculosis, 86, 34-40.
http://dx.doi.org/10.1016/j.tube.2005.06.003
[20] Ongkhammy, S., Anstutz, V., Baremes, H. and Buisson, Y. (2009) The Bleach Method Improves the Detection of Pulmonary Tuberculosis in Laos. The International Journal of Tuberculosis and Lung Disease, 13, 1124-1129.
[21] Aber, V.R., Allen, B.W., Mitchinson, D.A., Ayuma, P., Edwards, E.A. and Keyes, A.B. (1980) Quality Control in Tuberculosis Bacteriology. Laboratory Studies on Isolated Positive Cultures and the Efficiency of Direct Smear Examination. Tubercle, 61, 123-133. http://dx.doi.org/10.1016/0041-3879(80)90001-X
[22] Yassin, M., Cuveas, A.E.L., Gebrexabher, H. and Squire, S.B. (2003) Efficacy and Safety of Short-Term Digestion of Sputum in Case Finding for Pulmonary Tuberculosis in Ethiopia. The International Journal of Tuberculosis and Lung Disease, 7, 678-683.
[23] Iqbal, S., Amin, D., Mumtaz, A. and Shabir, I. (2010) Significance of Appropriate Sampling in the Diagnosis of Tuberculosis (TB)—A Comparison of Different Techniques. Biomedica, 26, 39-44.
[24] Negi, S.S., Khan, S.F., Gupta, S., Pasha, S.T., Khare, S. and Lal, S. (2005) Comparison of the Conventional Diagnostic Modalities, Bactec Culture and Polymerase Chain Reaction Test for Diagnosis of Tuberculosis. Indian Journal of Medical Microbiology, 23, 29-33. http://dx.doi.org/10.4103/0255-0857.13869
[25] Mindolli, P.B., SalMani, M.P. and ParandeKar, P.K. (2013) Improved Diagnosis of Pulmonary Tuberculosis Using Bleach Microscopy Method. Journal of Clinical and Diagnostic Research, 7, 1336-1338.
[26] James, A., Uba Abba, S., Ibrahim, A., Mbah, H., Musuluma, H., Ochei, K., Darboe, S. and Torpey, K. (2013) Improving the Case Detection of Pulmonary Tuberculosis by Bleach Microscopy Method in the North West of Nigeria. Journal of Medical Laboratory and Diagnosis, 4, 34-37.
http://dx.doi.org/10.5897/JMLD2013-0066
[27] Kalawat, U., Sharma, K.K., Reddy, P.N. and Kumar, A.G. (2010) Study of Bronchoalveolar Lavage in Clinically and Radiologically Suspected Cases of Pulmonary Tuberculosis. Lung India, 27, 122-124.

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.