Light Emitting Diode (LED) Fluorescent Microscopy: a Milestone in the Detection of Paucibacillary Mycobacterium in Case of Pulmonary Tuberculosis

Abstract

In Bangladesh with a large number of pulmonary tuberculosis cases and financial constraints with high HIV risk, evaluation of scanty i.e paucibacillary cases has great importance. To study the efficacy of Light Emitting Diode fluorescent microscopy in the diagnosis of pulmonary tuberculosis specially paucibacillary cases in comparison to conventional fluorescent microscopy, Ziehl-Neelsen staining and culture of sputum samples from patients suspected of pulmonary tuberculosis. 150 sputum samples collected from the patients suspected of pulmonary tuberculosis were processed by the Petroff's method, and subjected to Ziehl-Neelsen staining (ZN), which were examined by both LED and conventional fluorescent microscope (CFM) and culture on Lowenstein- Jensen media (gold standard) for detection of Mycobacterium tuberculosis. In this study, out of 150 patients 14.67%, 8.67%, 4% cases were detected as paucibacillary (Scanty) cases by LED, CFM, ZN respectively. LED fluorescent microscopy is more effective in the detection of paucibacillary cases of pulmonary tuberculosis than other methods of microscopic examination. DOI: http://dx.doi.org/10.3329/bmj.v40i1.9958 BMJ 2011; 40(1): 22-26

Comparison of Light-Emitting Diode Fluorescent Microscopy Against Bright-Field Microscopy and JD-TB-Antigen Test for the Diagnosis of Pulmonary Tuberculosis

“…In our study, the specificity ZN stained microscopy is 95.28% which is almost similar to the findings reported from Bangladesh specificity (97.61%) and Ethiopia (specificity of (96.5%)) ( [12,13]. When this finding is compared to the previous study results (91.3%) reported by Rahman and his colleagues, the specificity is higher [14].…”

Suitability of saliva for Tuberculosis diagnosis: comparing with serum

“…Smear microscopy, the most widely available TB diagnostic test has poor sensitivity [ 2 ]. Sputum culture, the gold standard has a long turnaround time (up to 42 days) [ 3 ], whereas the recently developed GeneXpert MTB/RIF test (Cepheid Inc., Sunnyvale, USA), although rapid, is expensive, amongst other limitations which hamper its use in resource-poor countries [ 4 ]. All these tests also depend on the quality of sputum provided by the patient, to yield reliable results.…”

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“…Golia S et al 14 proved that fluorescent staining was more efficient over ZN staining in determining paucibacillary pulmonary tuberculosis cases. Khatun Z et al 34 reported that only 4% cases of grade scanty were detected by ZN whereas LED fluorescent microscopy detected 14.67% cases. Thus Khatun Z et al 34 declared that fluorescent microscopy is a better method than ZN staining due to its close comparability to the gold standard culture technique.…”

“…Khatun Z et al 34 reported that only 4% cases of grade scanty were detected by ZN whereas LED fluorescent microscopy detected 14.67% cases. Thus Khatun Z et al 34 declared that fluorescent microscopy is a better method than ZN staining due to its close comparability to the gold standard culture technique. Studies by Golia S et al 14 and Khatun et al 34 noted that more paucibacillary cases were detected by fluorescent microscopy as compared to ZN light microscopy.…”

“…Thus Khatun Z et al 34 declared that fluorescent microscopy is a better method than ZN staining due to its close comparability to the gold standard culture technique. Studies by Golia S et al 14 and Khatun et al 34 noted that more paucibacillary cases were detected by fluorescent microscopy as compared to ZN light microscopy. Therefore, Auramine O fluorescent staining increases the diagnostic value of the sputum smear, especially in paucibacillary specimens that are likely to be missed on ZN staining.…”