TABLE 1.
Laboratory | Decontaminationa | Stain for microscopyb | Inoculation procedurec
|
|
---|---|---|---|---|
Respiratory specimens | Nonrespiratory specimens | |||
A | 2% NaOH-NALC | Auramine | BACTEC 12B ± L-J | BACTEC 12B + L-J |
B | 2% NaOH-NALC | Auramine | BACTEC 12B + L-J | BACTEC 12B + L-J |
C | 2% NaOH-NALC | Auramine | MB/BacT + L-J | MB/BacT + L-J |
D | 2% NaOH | Z-N | L-J (±BACTEC 12B) | BACTEC 12B + L-J |
NALC, N-acetyl-l-cysteine. Laboratories A and D used 1 M phosphoric acid to halt digestion and decontamination, while laboratories B and C used phosphate-buffered saline (up to a 50-ml total volume). Specimens were concentrated by centrifugation (2,300 to 3,220 × g).
Smear samples were stained by the Ziehl-Neelsen (Z-N) technique, the auramine fluorochrome method (with all new smear-positive specimens confirmed by Ziehl-Neelsen overstaining).
After processing, respiratory and nonrespiratory specimens were inoculated into BACTEC 12B vials (Becton Dickinson, Sparks, Md.), MB/BacT broth (Organon Teknika Corp. Durham, N.J.), and/or onto Löwenstein-Jensen (L-J) slants. Details on the incubation temperatures and reading schedules used in each laboratory are available from the authors upon request. ±, with or without.