Triton Ziehl-Neelsen technique does not improve detection of TB bacilli in sputum

Abstract

Background: Addition of Triton X 100 reagent to conventional Ziehl-Neelsen staining has been shown to improve detection of tuberculosis bacilli in CSF to diagnose TB meningitis. We evaluated its performance in sputum in the diagnosis of pulmonary tuberculosis. Methods: We compared the Triton ZN technique with the conventional ZN method on the sputum of 68 patients suspected with pulmonary tuberculosis by Bland Altman agreement analysis. Results: The Triton ZN technique detected lower number of bacilli than the conventional AFB staining method at all the tested concentrations of Triton X100 by a mean difference in the AFB score ranging from 0.2 to 0.5. Conclusions: Our study suggests that Triton X 100 added to conventional ZN staining does not improve detection of M. tuberculosis in sputum.