A method is presented for the decontamination, liquefaction, and concentration of sputum specimens that are in transport more than 24 h. The method is inexpensive, and culture results compare well with those obtained with the accepted N-acetyl-L-cysteine and sodium hydroxide method for the isolation of tubercle bacilli. The working solution, 1% cetylpyridinium chloride and 2% sodium chloride, is mixed in equal volumes with sputum before the specimens are shipped. Tubercle bacilli remained viable after 8 days of exposure to this solution. Only Lowenstein-Jensen medium was used because the cetylpyridinium chloride in the inoculum remains active on 7H10 or other agar base media and partially inhibits the growth of tubercle bacilli.

Polycarbonate membrane filters were used to concentrate 916 sputum specimens for detecting acid-fast bacilli by microscopic examination. These results were compared with those of smears prepared from centrifugates and direct smears of the same specimens. Culture isolation, the control procedure, demonstrated the presence of acid-fast bacilli in 76 specimens. The number of positive specimens detected by microscopy was 82 on polycarbonate membrane filter concentrates, with an 80.2% sensitivity; 53 on centrifugate smears, with a 62.2% sensitivity; and 44 on direct smears, with a 55.8% sensitivity. Acid-fast microscopy results demonstrated that the sensitivity of the polycarbonate membrane filter sputum concentration method was superior to that of the recommended centrifuge concentration method and that the former method may be considered a rapid alternative when culture for acid-fast bacilli is impractical.

A method is presented for preparing smears for proficiency testing and quality control in acid-fast microscopy. The work was prompted by the increased demand for acid-fast bacilli positive smears with characteristic microscopic appearance and among-smear uniformity.