Utility of modified bleach concentration method for detecting Acid Fast Bacilli in Tubercular lymphadenitis compared with CBNAAT

Surasura, Harshavardan; Sree M, Bharathi; Vubbara, Anupama; Gali, Sai Chandana; Gattamneni, Indrani

doi:10.61186/rabms.10.3.291

Volume 10, Issue 3 (7-2024) Journal of Research in Applied and Basic Medical Sciences 2024, 10(3): 291-298 | Back to browse issues page

‎ 10.61186/rabms.10.3.291

Ethics code: Lr.No.159/2023, dated 07/09/2023

Mendeley

Zotero

RefWorks

Surasura H, Sree M B, Vubbara A, Gali S C, Gattamneni I. Utility of modified bleach concentration method for detecting Acid Fast Bacilli in Tubercular lymphadenitis compared with CBNAAT. Journal of Research in Applied and Basic Medical Sciences 2024; 10 (3) :291-298
URL: http://ijrabms.umsu.ac.ir/article-1-340-en.html

Utility of modified bleach concentration method for detecting Acid Fast Bacilli in Tubercular lymphadenitis compared with CBNAAT

Harshavardan Surasura

, Bharathi Sree M

, Anupama Vubbara

, Sai Chandana Gali ^*

, Indrani Gattamneni

Assistant Professor, Department of Pathology, S.V. Medical College, Tirupati, Andhra Pradesh, India , chandana.gali@gmail.com

Abstract: (292 Views)

Background & Aims: Tuberculosis is a significant health problem in developing countries like India, with lymphadenitis being the most common presentation among various types of extrapulmonary tuberculosis. This study aims to evaluate the efficacy of the modified bleach concentration method in detecting Acid Fast Bacilli (AFB) compared to the conventional Ziehl-Neelsen (ZN) staining method.
Materials & Methods: A cross-sectional and observational study was conducted for six months, involving 146 cases of suspected clinical TB with lymphadenopathy referred for Fine-Needle Aspiration Cytology (FNAC). Aspirates were processed for direct microscopy using conventional ZN staining and routine cytology, and compared with the findings of the modified bleach method. The remaining material was subjected to Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) assay.
Results: Among 146 cases, 44 cases were positive for AFB stain on conventional ZN staining, while 49 cases were positive for AFB using the modified bleach method. The modified bleach method showed a sensitivity of 98%, specificity of 98%, positive predictive value of 96%, and negative predictive value of 99% compared to CBNAAT.
Conclusion: The modified bleach method is more sensitive than the conventional Ziehl-Neelsen method and is efficient in demonstrating the presence of AFB on cytology smears. It is also safe, easy to perform, and inexpensive. Therefore, the modified bleach method can be a valuable tool in the diagnosis of TB lymphadenopathy.

Keywords: Acid Fast Bacilli, Ziehl-Neelson stain, Bleach, CBNAAT

Full-Text [PDF 425 kb] (174 Downloads)

Type of Study: orginal article | Subject: General

References

1. Global tuberculosis report 2023. World Health Organization. 2023. Available from: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023. Accessed 2024 Jul 31. [GOOGLE BOOKS]

2. World Health Organization. Definitions and reporting framework for tuberculosis - 2013 revision: updated December 2014 and January 2020. 2013. Available from: https://www.who.int/publications-detail-redirect/9789241505345. Accessed 2024 Jul 31. [GOOGLE SCHOLAR]

3. Fontanilla JM, Barnes A, Von Reyn CF. Current diagnosis and management of peripheral tuberculous lymphadenitis. Clin Infect Dis 2011;53:555-62. [DOI:10.1093/cid/cir454] [PMID]

4. Gopalaswamy R, Dusthackeer VA, Kannayan S, Subbian S. Extrapulmonary tuberculosis-an update on the diagnosis, treatment and drug resistance. Journal of Respiration 2021;1(2):141-64. doi: 10.3390/jor1020015. [DOI:10.3390/jor1020015]

5. Srinivas CV, Nair S. Indian J Otolaryngol Head Neck Surg. 2019;71:205-11. [DOI:10.1007/s12070-017-1235-x] [PMID] []

6. Medeiros LJ. Chapter 22, Mycobacterium tuberculosis Lymphadenitis. In: Ioachim's Lymph Node Pathology. Philadelphia, PA: Lippincott Williams and Wilkins; 2009.

7. Laddha A, Bhake A, Kediya A, Vagha S. Comparative Study of Conventional Ziehl-Neelsen Method and Modified Bleach Concentration Method in Detection of Tubercle Bacilli in Fine-Needle Aspiration Material of Lymph Nodes. J Datta Meghe Inst Med Sci Univ 2021;16:349-53. [GOOGLE SCHOLAR]

8. Purushothaman G, Sekar M, Balaraman S. J Evol Med Dent Sci. 2020;9(14):1175-9. [DOI:10.14260/jemds/2020/255]

9. Singh P, Rathi M, Verma N, Singh N, Tapparwal V. Modified bleach method for detection of acid-fast bacilli in lymph node aspirates and its comparison with the conventional Ziehl-Neelsen stain. Int J Adv Med Health Res 2015;2(2):83. doi: 10.4103/2349-4220.172882. [DOI:10.4103/2349-4220.172882]

10. Gill CM, Dolan L, Piggott LM, McLaughlin AM. New developments in tuberculosis diagnosis and treatment. Breathe 2022;18(1):210149. https://doi: 10.1183/20734735.0149-2021. [DOI:10.1183/20734735.0149-2021] [PMID] []

11. World Health Organization. WHO operational handbook on tuberculosis. Module 3: diagnosis-rapid diagnostics for tuberculosis detection. World Health Organization; 2024 Mar 15. [GOOGLE BOOKS]

12. Chandrasekhar B, Prayaga AK. Utility of concentration method by modified bleach technique for the demonstration of acid-fast bacilli in the diagnosis of tuberculous lymphadenopathy. J Cytol 2012;29(3):165-8. https://doi: 10.4103/0970-9371.101160. [DOI:10.4103/0970-9371.101160] [PMID] []

13. Annam V, Karigoudar MH, Yelikar BR. Indian J Pathol Microbiol. 2009;52(3):349-52. https://doi: 10.4103/0377-4929.54991. [DOI:10.4103/0377-4929.54991] [PMID]

14. Ghosh S, Mandal P, Banerjee A, Banerjee U. Muller J Med Sci Res. 2021;12(2):80. https://doi: 10.4103/mjmsr.mjmsr_32_21. [DOI:10.4103/mjmsr.mjmsr_32_21]