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"Typical clinical symptoms and chest X-ray is a marker of Tuberculosis (TB) sufferers. However, the diagnosis of TB in adults should be supported by microscopic examination. Currently, Bacilli microscopic examination of acid-fast bacilli (AFB) in sputum by Ziehl-Neelsen (ZN) coloring is the most widely used. However, for reasons of convenience,especially for laboratories with a considerable amount of smear samples, and due to higher sensitivity compared with ZN staining, the World Health Organization (WHO) has recommended the use of auramine-O-staining (fluorochrome staining), which is visualized by light emitting diode (LED) fluorescence microscopy. The aim of this study was to evaluate the performance of modified light microscope with homemade LED additional attachment for examination ofAFB in sputum using auramine-O-staining method. We compared the sensitivity and specificity of 2 kinds of AFB in sputum methods: ZN and fluorochrome, using culture on Lowenstein-Jensen media as the gold standard. The results showed auramine-O-staining gives more proportion of positive findings (81%) compared to the ZN method (70%). These results demonstrated that the sensitivity of auramine-O-staining was higher than ZN, however it gives more potential false positive results than ZN. The sensitivity of auramine-O-staining in detecting AFB in sputum was 100% while the specificity was 88%."

"ABSTRAKPendahuluan : Deteksi Basil Tahan Asam (BTA) Ziehl Neelsen cairan serebrospinal (CSS) di RSUPN dr Cipto Mangunkusumo tahun 2014 tidak pernah positif. Pewarnaan Auramine-O dapat meningkatkan sensitivitas deteksi BTA. Perlu modifikasi sitosentrifugasi pada pulasan BTA, agar dapat deteksi BTA lebih banyak dan cepat.Metode: uji diagnostik pulasan BTA CSS Ziehl Neelsen metode non sitosentrifugasi, Cytospin, Cytopro serta Auramine-O Cytopro dibandingkan dengan baku emas biakan TB MGIT.Hasil: Uji diagnostik BTA Ziehl Neelsen tanpa sitosentrifugasi, tidak dapat dinilai karena BTA tidak terdeteksi di semua sampel. Uji diagnostik Ziehl Neelsen Cytospin dan Cytopro sama yaitu sensitivitas 64%, spesifisitas 85%, NPP 54%, NPN 89 %. Uji diagnostik Auramine-O Cytopro, sensitivitas 91%, spesifisitas 26%, NPP 26%, NPN 91 %.Kesimpulan: Pulasan BTA CSS metode sitosentrifugasi dapat menggantikan metode non sitosentrifugasi. Pulasan BTA CSS Auramine-O dapat me rule out diagnosis meningitis TB.

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ABSTRACT

Introduction: Detection of AFB from CSF with Ziehl Neelsen staining in 2014 at dr Cipto Mangunkusumo general hospital never gives positive result. Staining with Auramine-O smear staining can increase its sensitivity. Acid fast bacilli cytocentrifugation is needed as a modification in AFB slide preparation to gain more bacilli faster.

Methods: Diagnostic perfomance of AFB slide prepared by non cytocentrifugation, Cytospin, Cytopro with Ziehl Neelsen stain, prepared by cytopro with Auramine-O stain are compared to TB MGIT as a gold standard.

Results: Acid fast bacilli slide prepared with non cytocentrifugation method and stained by Ziehl Neelsen cannot be obtained because AFB was not detected in all samples. Acid fast bacilli slide prepared with Cytospin and Cytopro and stained with Ziehl Neelsen has sensitivity (64%), specificity (85%), PPV (54%), 89% NPV. Acid fast bacilli slide prepared with Cytopro and stained with Auramine-O has sensitivity (91%), specificity (26%), PPV (26%), 91 % NPV.

Conclusion: Detection of AFB from CSF with cytocentrifugation method can replace non cytocentrifugation method. Acid fast bacilli slide prepared cytocentrifugation and stained by Auramine-O can rule out Tuberculous meningitis."