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Journal of Clinical Microbiology, July 2005, p. 3460-3462, Vol. 43, No. 7
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.7.3460-3462.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Improved Sensitivity of Sputum Smear Microscopy after Processing Specimens with C18-Carboxypropylbetaine To Detect Acid-Fast Bacilli: a Study of United States-Bound Immigrants from Vietnam

K. F. Laserson,1* N. T. N. Yen,2 C. G. Thornton,3 V. T. C. Mai,2 W. Jones,1,4 D. Q. An,2 N. H. Phuoc,2 N. A. Trinh,2 D. T. C. Nhung,1 T. X. Lien,5 N. T. N. Lan,5 C. Wells,1 N. Binkin,1 M. Cetron,1 and S. A. Maloney1

Centers for Disease Control and Prevention, Atlanta, Georgia,1 Cho Ray Hospital, Ho Chi Minh City, Vietnam,2 Integrated Research Technology, LLC, Baltimore, Maryland,3 International Organization of Migration, Ho Chi Minh City, Vietnam,4 Institute Pasteur, Ho Chi Minh City, Vietnam5

Received 17 November 2004/ Returned for modification 10 January 2005/ Accepted 3 March 2005

The goal of this study was to evaluate the effect of the specimen-processing method that uses the detergent C18-carboxypropylbetaine (CB-18) on the sensitivity of acid-fast bacillus (AFB) staining. Vietnamese immigrants with abnormal chest radiographs provided up to three sputum specimens, which were examined for acid-fast bacilli by use of direct auramine and Ziehl-Neelsen staining. The remaining sputum was split; half was cultured, and the other half was incubated with CB-18 for 24 h, centrifuged, and examined for AFB by both staining methods. CB-18 processing improved the sensitivity of AFB staining by 20 to 30% (only differences in auramine sensitivity were statistically significant) but reduced specificity by {approx}20% (P < 0.05). These findings have direct utility for overseas migrant tuberculosis screening programs, for which maximizing test sensitivity is a major objective.

* Corresponding author. Mailing address: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-10 Atlanta, GA 30333. Phone: (404) 639-5334. Fax: (404) 639-1566. E-mail: klaserson{at}cdc.gov.

Journal of Clinical Microbiology, July 2005, p. 3460-3462, Vol. 43, No. 7
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.7.3460-3462.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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