DIAGNOSTIC PERFORMANCE OF ZIEHL-NEELSEN STAINING AND AURAMINE-RHODAMINE STAINING TECHNIQUES IN THE DETECTION OF PULMONARY AND EXTR APULMONARY TUBERCULOSIS

Tapia-Sequeiros G.; Hueda-Zavaleta M.; Gómez de la Torre J.C.; Hernandez-Vargas A.; Barletta-Carrillo C.; Flores C.; Piscoche C.; Miranda C.; Mendoza A. · Revista Peruana de Medicina Experimental y Salud Publica (2025) · DOI: 10.17843/rpmesp.2025.421.14062

Resumen

Objective. To determine the diagnostic performance of Ziehl-Neelsen and Auramine-Rhodamine staining for pulmonary and extrapulmonary tuberculosis. Materials and methods. This was a cross-sectional diagnostic test study. We used a database of processed samples from patients with suspected pulmonary and extrapulmonary tuberculosis in a private laboratory in Peru between 2011 and 2022. Ziehl-Neelsen staining and Auramine-Rhodamine staining were the index tests. The reference tests were Xpert MTB/RIF and Xpert Ultra. The receiver operating characteristics and area under the curve (AUC/ROC) were calculated to determine the diagnostic performance of each staining technique. Results. We analyzed 908 samples processed by Ziehl-Neelsen staining and 623 samples by Auramine-Rhodamine staining, most were lung tissue samples. Using the Xpert MTB/RIF as a reference test, the Ziehl-Neelsen staining obtained an AUC=0.72, a sensitivity of 44.2% and specificity of 99.3%; and Auramine-Rhodamine staining showed an AUC=0.73, a sensitivity of 46.8% and specificity of 100%. Considering the Xpert Ultra test as a reference, the diagnostic performance for Ziehl-Neelsen showed an AUC=0.63 with a sensitivity of 26.9% and specificity of 98.5%; and an AUC=0.64 with a sensitivity of 30% and specificity of 98.2% for the Auramine-Rhodamine staining. Conclusion. The diagnostic performance for both staining techniques is fair, and decreases when taking Xpert Ultra as a reference. New diagnostic alternatives with adequate performance are needed to detect tuberculosis.

Instituciones: Universidad Nacional Daniel Alcides Carrión; Universidad Privada de Tacna