II. Background

  1. Lipid rich cell walls (Mycobacterium, Nocardia) retain red stain on Acid Fast Staining

III. Technique

  1. Carbolfuchsin (red stain) is applied to a sample smear and then heated
  2. Acid Alcohol (HCL 3% and 95% Ethanol) is applied to smear to remove red stain
    1. Despite the acid Alcohol application, lipid rich cell walls retain the red stain
  3. Methylene blue stain is applied as a counter stain

IV. Interpretation

  1. Acid Fast Positive
    1. Lipid-rich cell walls retain red stain
    2. Acid Fast Bacilli
      1. Mycobacterium species
      2. Nocardia species (partially acid-fast, also considered Gram Positive)
    3. Non-Bacteria may also be acid-fast (e.g. Bacterial endospores, Cryptosporidium parvum)
  2. Acid Fast Negative
    1. Non-Acid Fast Bacteria instead stain blue

V. Resources

  1. Acid Fast Bacteria (StatPearls)
    1. https://www.ncbi.nlm.nih.gov/books/NBK537121/
  2. Acid Fast Stain Protocol (American Society of Microbiology)
    1. https://asm.org/ASM/media/Protocol-Images/Acid-Fast-Stain-Protocols.pdf?ext=.pdf

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Related Studies

Ontology: acid-fast bacteria (C0597955)

Concepts Bacterium (T007)
SnomedCT 39701000009103
English acid-fast bacteria, acid bacteria fasting, acid fast bacteria, acid bacteria fast, Acid-fast bacteria, Acid-fast bacterium (organism), Acid-fast bacterium

Ontology: Acid fast stain positive (C0855688)

Concepts Laboratory or Test Result (T034)
English Acid fast stain positive
Spanish Tinción acidorresistente positiva
Portuguese Coloração acidorresistente positiva
Italian Colorazione acido-resistente positiva
French Coloration acidorésistante (Ziehl-Neelsen) positive
German saeureechte Faerbung positiv
Dutch zuurvaste kleuring positief
Czech Barvení na acidorezistentní tyčinky pozitivní
Japanese 抗酸染色陽性, コウサンセンショクヨウセイ
Hungarian Saválló festés pozitív

Ontology: Acid fast stain (C1318720)

Concepts Indicator, Reagent, or Diagnostic Aid (T130)
SnomedCT 406976001
English acid fast stain, acid fast, acid fast stains, fast acid stain, acid fast staining, Acid fast stain (substance), Acid fast, Acid fast stain
Spanish colorante acidorresistente (sustancia), colorante acidorresistente

Ontology: Ziehl-Neelsen stain method (C1318721)

Definition (HL7V3.0) <p>Stain, Acid fast, Ziehl-Neelsen</p>
Definition (NCI_CDISC) A microscopy acid fast staining method that utilizes Ziehl-Neelsen carbol fuchsin, acid alcohol and methylene blue, to determine the presence of acid fast microorganisms. This acid fast staining technique requires heating during the primary staining step involving the carbol fuchsin.
Definition (NCI) A microscopy acid fast staining method that utilizes Ziehl-Neelsen carbol fuchsin, acid alcohol and methylene blue, to determine the presence of acid fast microorganisms. This acid fast staining technique requires heating during the primary staining step involving the carbol fuchsin.
Concepts Laboratory Procedure (T059)
SnomedCT 48493000, 406979008
HL7 0146
LNC LP6097-2
Spanish tinción acidorresistente, método de Ziehl - Neelsen, método de tinción acidorresistente con técnica de Ziehl - Neelsen (procedimiento), método de tinción acidorresistente con técnica de Ziehl - Neelsen, tinción acidorresistente, método de Ziehl - Neelsen (procedimiento), método de tinción de Ziehl-Neelsen (procedimiento), método de tinción de Ziehl-Neelsen
English Acid fast stain, Ziehl-Neelsen method, Ziehl Neelsen Acid Fast Staining Method, Acid fast stain.Ziehl-Neelsen, Acid fast Ziehl-Neelsen stain method (procedure), Acid fast Ziehl-Neelsen stain method, Acid fast Ziehl-Neelsen stain, ZIEHL NEELSEN ACID FAST STAIN, Ziehl-Neelsen stain, Ziehl-Neelsen stain method (procedure), Ziehl-Neelsen stain method, Acid fast stain, Ziehl-Neelsen method (procedure), Acid fast stain, Ziehl-Neelsen