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Inefficiency of 0.3% Carbol Fuchsin in Ziehl-Neelsen Staining for Detecting Acid-Fast Bacilli

Tuberculosis Research Centre, Indian Council of Medical Research, Chennai, 600 031 Tamil Nadu,¹ Government Hospital for Thoracic Medicine, Tambaram Sanatorium, Chennai, 600 047 Tamil Nadu,² South-East Asia Regional Office, World Health Organization, New Delhi, India³

Received 4 February 2002/ Returned for modification 25 March 2002/ Accepted 17 May 2002

We compared the sensitivity and specificity of a modified Ziehl-Neelsen (modified-ZN) staining method for acid-fast bacilli (AFB) with that of the standard Ziehl-Neelsen (standard-ZN) staining method, using culture results with Mycobacterium tuberculosis as the "gold standard." The sensitivity (72%; 101 of 140) of the modified-ZN staining method, which uses 0.3% carbol fuchsin, was significantly lower than that of the standard-ZN staining method (84%; 117 of 140); the modified-ZN method missed 21% of cases detected by the standard-ZN method and 11% more of culture-positive samples than the standard-ZN method. The World Health Organization recommendation of 0.3% carbol fuchsin in the ZN method for staining AFB needs to be reconsidered.

This article has been cited by other articles:

• Angra, P., Ridderhof, J., Smithwick, R. (2003). Comparison of Two Different Strengths of Carbol Fuchsin in Ziehl-Neelsen Staining for Detecting Acid-Fast Bacilli. J. Clin. Microbiol. 41: 3459-3459 [Full Text]