title: Modified cytospin slide microscopy method for rapid diagnosis of smear-negative pulmonary tuberculosis.
abstract: OBJECTIVE
  To evaluate a modified method of the Ziehl-Neelsen stain and determine whether it improves the detection rate of acid-fast bacilli (AFB) in bronchoalveolar lavage fluid (BALF) specimens.
  
  
  METHODS
  Bronchoscopy of patients with suspected smear-negative pulmonary tuberculosis (PTB) patients was conducted to collect BALF to assess the efficacy and accuracy of the modified method for PTB diagnosis.
  
  
  RESULTS
  A total of 106 BALF specimens was collected from 74 PTB patients on the basis of BALF samples that were culture-positive for Mycobacterium tuberculosis. When analysed by patient, the sensitivity and specificity of our modified method were respectively 87.8% and 99.6%, while the positive predictive (PPV) and negative predictive values (NPV) were respectively 98.5% and 96.8%. Conversely, the sensitivity of direct smears and concentrated smears was respectively 16.2% and 37.8%, with 100% specificity. On analysing 106 samples, the culture positivity rate of the direct smear and the concentrated smear methods was respectively 76.4%, 13.2% and 34%, while it was 91.5% for the modified method.
  
  
  CONCLUSIONS
  The sensitivity of our modified method was significantly higher than that of direct or concentrated smears. Overall, the modified method improved the detection rate of AFB in BALF specimens, and provided an efficient and accurate diagnosis of PTB in patients with suspected smear-negative PTB.
authors.affiliation: Laboratory of Molecular Biology for Tuberculosis, Beijing Key Laboratory on Drug-Resistant Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People's Republic of China.
authors.forename: L-H
authors.initials: LH
authors.lastname: Zheng
authors.affiliation: Laboratory of Molecular Biology for Tuberculosis, Beijing Key Laboratory on Drug-Resistant Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People's Republic of China.
authors.forename: H-Y
authors.initials: HY
authors.lastname: Jia
authors.affiliation: Shijiazhuang Fifth Hospital, Hebei, People's Republic of China.
authors.forename: X-J
authors.initials: XJ
authors.lastname: Liu
authors.affiliation: Laboratory of Molecular Biology for Tuberculosis, Beijing Key Laboratory on Drug-Resistant Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People's Republic of China.
authors.forename: H-S
authors.initials: HS
authors.lastname: Sun
authors.affiliation: Laboratory of Molecular Biology for Tuberculosis, Beijing Key Laboratory on Drug-Resistant Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People's Republic of China.
authors.forename: F-J
authors.initials: FJ
authors.lastname: Du
authors.affiliation: Laboratory of Molecular Biology for Tuberculosis, Beijing Key Laboratory on Drug-Resistant Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People's Republic of China.
authors.forename: L-P
authors.initials: LP
authors.lastname: Pan
authors.affiliation: National Clinical Laboratory on Tuberculosis, Beijing Key Laboratory on Drug-Resistant Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People's Republic of China.
authors.forename: H-R
authors.initials: HR
authors.lastname: Huang
authors.affiliation: Laboratory of Molecular Biology for Tuberculosis, Beijing Key Laboratory on Drug-Resistant Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People's Republic of China.
authors.forename: Z-D
authors.initials: ZD
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D001999:Bronchoscopy; D006801:Humans; D008853:Microscopy / Q000379:methods*; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012680:Sensitivity and Specificity; D013048:Specimen Handling; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*; D055815:Young Adult