Bleach method in comparison with NALC-NaOH specimen processing method for the detection of mycobacterium in sputum specimen

Background: Tuberculosis is an infectious disease still remains to be a foremost public health risk worldwide. Even though there is an availability of many highly sensitive diagnostic tools, early case detection plays a significant role in control of the disease which relies specially on the detection of acid-fast bacilli in clinical samples which is low sensitive. Earlier decontamination of sputum sample may improve the detection of mycobacterium.Methods: A prospective study was conducted with a total of (N=464) clinically suspected TB patient sputum samples which were collected and processed directly for AFB. From which AFB +ve samples were excluded. The direct AFB -ve (N=279) samples were processed using concentration methods (NALC, Bleach). After concentration, smears were examined under oil immersion for acid fast bacilli by ZN staining.Results: Out of 464 sputum samples, 185 direct ZN stain +ve were excluded. Among the ZN-ve (N=279) samples, n=44 (15.7%) were positive using bleach method. The positivity has improved to n=48 (17.2%) using NALC-NaOH.Conclusions: Bleach method of sputum decontamination is comparable to standard NALC-NaOH method. Therefore, we conclude that the identification of AFB using bleach concentration method can be used in resource limited health care setups especially in laboratories where mycobacterial culture is not performed which might help us in early diagnosis of tuberculosis

Isolation and identification of candida species from various clinical samples in a tertiary care hospital

Background: Candida spp is a member of the normal flora of the skin, mucous membrane and gastrointestinal tract. They are endogenous opportunists which cause secondary infection in individuals with underlying immunocompromised conditions. Candidiasis is a common fungal disease in humans. An increase in the prevalence of non-albicans species has been noted during the last decades because of increasing use of azoles. This study aims to Spectate Candida using chromogenic medium.Methods: A total of 50 Candida isolates from various clinical samples were included in the study. These isolates were subjected to gram's stain, germ tube test and inoculation on commercially available CHROM agar (HiMedia India).Results: In current study majority of isolates were from high vaginal swab (34%) followed by sputum (28%), urine (18%), pus from surgical sites and others constituted to 20%. Candida albicans (51%) was the most common candida species, followed by C. tropicalis (25%), C. krusei (16%), C. glabrata (6%) and C. dubliniensis (1%).Conclusions: Along with Candida albicans, non-albicans candida spp like C. tropicalis, C. krusei, C. glabrata, and C. dubliniensis are increasingly being isolated from clinical samples. CHROM agar is a simple, rapid and inexpensive method for identification of such species. Characterization to species level helps to identify species which might be intrinsically resistant to commonly used antifungal agents