Technical Guide

By Kim, Sang Jae

Book Id: WPLBN0000125161
Format Type: PDF eBook:
File Size: 0.7 MB
Reproduction Date: 2005

Title:	Technical Guide
Author:	Kim, Sang Jae
Volume:
Language:	English
Subject:	Health., Medical research, Medical reports
Collections:	Medical Library Collection
Historic Publication Date:
Publisher:	Centers for Disease Control and Prevention


Citation APA MLA Chicago Jae Kim, B. S. (n.d.). Technical Guide. Retrieved from http://www.gutenberg.us/

Excerpt
A technical guide for sputum smear microscopy, based on one initiated in 1969 by Dr J Holm, the then Director of the International Union against Tuberculosis, was first published in 1978 by the IUAT as the Technical Guide for Sputum Examination for Tuberculosis by Direct Microscopy. The guide was included in the third and fourth editions of the IUATLD’s Tuberculosis Guide for Low Income Countries. It was designed to be a simple reference standard for the collection, storage and transport of sputum specimens and for the examination of sputum smears by direct microscopy. It was meant to address the needs of health care workers in low income, high prevalence countries which represent the bulk of the global tuberculosis caseload.

Table of Contents
TABLE OF CONTENTS 1. SPUTUM MICROSCOPY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.1 Aims of tuberculosis laboratory diagnostic and follow-up services . . . . . . . . . . . 1 1.2 “Spot”, “morning” and “spot” sputum specimens. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.3 “Morning” specimens for follow-up. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.4 Sputum containers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.5 Collection of sputum specimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.6 Transportation of sputum specimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 2. THE SPUTUM SMEAR MICROSCOPY LABORATORY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2.1 Role of the laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 2.2 Physical environment of the laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 3. THE STAINING METHOD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 3.1 Preparation of Ziehl-Neelsen reagents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 3.1.1 Ziehl’s carbol fuchsin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 3.1.2 Aqueous phenol solution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 3.1.3 Decolourising agent solutions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 3.1.4 Methylene blue counterstaining solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 3.2 Smear preparation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 3.2.1 Smearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 3.2.2 Fixing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3.2.3 Staining. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 3.2.4 Decolourising. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 3.2.5 Counterstaining . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 3.2.6 Quality of smearing and staining. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 4. MICROSCOPIC EXAMINATION OF SPUTUM SMEARS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 4.1 The microscope. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 4.2 Operating the microscope. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 4.3 Microscopic examination of smears. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 4.4 Grading of sputum smear microscopy readings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 4.5 Preservation of smears for quality assurance testing . . . . . . . . . . . . . . . . . . . . . . . . . . 15 5. RECORDING AND REPORTING OF SMEAR MICROSCOPY RESULTS . . . . . . . . . . . . . . 15 5.1 The laboratory registe