title: Comparison of Lumin LED fluorescent attachment, fluorescent microscopy and Ziehl-Neelsen for AFB diagnosis.
abstract: METHODS
  Cross-sectional studies in Russia (n = 502) and Macedonia (n = 205), with fluorochrome-stained sputum examined by 1) the new Lumin light emitting diode (LED) fluorescent attachment on a light microscope, and 2) conventional fluorescent microscope (CFM) available in each laboratory, and compared to 3) Ziehl-Neelsen (ZN) restaining/reading of the same smears. Poor readings of ZN-restained smears in Russia stimulated a retrospective laboratory registry analysis for sensitivity and specificity of directly ZN-stained smears (n = 791) from a previous period.
  
  
  RESULTS
  In Macedonia, the sensitivity of the Lumin and CFM were 87.8%, and that of restained ZN smears with conventional light microscope was 78.0%. In Russia, sensitivity was as follows: Lumin 72.8%, CFM 52.5%; re-stained ZN smears 28.5% and directly ZN stained smears 55.6%.
  
  
  CONCLUSIONS
  Fluorescence microscopy is more sensitive than conventional microscopy. The Lumin attachment to conventional light microscopes provided results equal to or better than the CFMs. Smear restaining for ZN showed a 12% advantage for Lumin and CFM in Macedonia, in line with other meta-analyses. Restaining for ZN gave poor results in Russia for unknown reasons. Retrospective analysis of directly ZN-stained smears showed 55.6% sensitivity compared to the Lumin (72.8%), which is also in line with the superiority of fluorescent microscopy reported in literature.
authors: alexandertrusov@gmail.com
authors: Alexander
authors: A
authors: Trusov
authors: R
authors: R
authors: Bumgarner
authors: R
authors: R
authors: Valijev
authors: R
authors: R
authors: Chestnova
authors: S
authors: S
authors: Talevski
authors: C
authors: C
authors: Vragoterova
authors: E S
authors: ES
authors: Neeley
mesh_terms: D001576:Benzophenoneidum; D015169:Colony Count, Microbial; D004396:Coloring Agents; D003430:Cross-Sectional Studies; D006801:Humans; D008856:Microscopy, Fluorescence / Q000295:instrumentation*; D011446:Prospective Studies; D018843:Republic of North Macedonia; D012426:Russia; D012666:Semiconductors; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*
chemical_list: D004396:Coloring Agents; D001576:Benzophenoneidum