Assessment of the Results of Erlich Ziehlneelsen and Fluorochrome Staining Procedures, Bactec 460 and Löwenstein-Jensen Culturing Procedures in the Diagnosis of Tuberculosis

ABSTRACT

The Ziehl-Neelsen (ZN) and fluorochrome (FC) staining procedures and the Bactec and Löwenstein-Jensen (L-J) culturing procedures were used to test 340 clinical specimens for tuberculosis, and the diagnostic value of the fluorochrome procedure was investigated. Positive cultures were obtained from 34 specimens (10%), of which 13 (3.8%) tested positive in ZN, and 18 (5.3%) in FC. Sensitivity of the ZN and FC staining results was found to be 38.2% and 52.9%, respectively. NAP (p-nitro-α-acetylamino-β-hidroxypropiophenone) identified 32 (94.1%) of the 34 strains as M. tuberculosis complex, and 2 (5.9%) as Mycobacteria other than tuberculosis (MOTT) bacilli. Twenty-one (61.7%) of the 34 culture-positive specimens grew only in Bactec 12 B medium, 2 (5.9%) grew only in L-J medium, and 11 (32.3%) grew in both Bactec and L-J media. The 32 M. tuberculosis complex strains' sensitivities to streptomycin (STR), isoniazid (INH), rifampin (RIF), and ethambutol were assessed with the Bactec system. Four (12.5%) of these strains were resistant to streptomycin, 9 (28.1%) to isoniazid, 7 (21.8%) to rifampin, and 6 (18.7%) to ethambutol. Total drug resistance was 43.7%. Six strains (18.7%) were resistant to 1 drug, 5 (15.6%) to 2 drugs, 2 (6.2%) to 3 drugs, and 1 (3.1%) to all 4 drugs, isoniazid plus rifampin resistance was seen in 18.7%.