Acid-Fast Stains Clinical Microbiology Review 209
STAIN PRIMARY STAIN DECOLORIZER COUNTERSTAIN APPEARANCE OF AFB OTHER
Ziehl-NeelsenKinyounFluorochromeAFB = acid fast bacilli. OI = oil immersion.
Requires heat. Examine at
least 300 OI fields. Wipe
lens after pos smears to
avoid cross-contamination
& false pos.Cold stain. Examine at least
300 OI fields. Wipe lens
after pos smears to avoid
cross-contamination &
false pos.More sensitive than carbol-
fuchsin. Faster to read.
Can examine at 250×.
Read immediately or store
at 2°C–8°C in dark to avoid
fading. Examine at least
300 fields. Pos should be
confirmed with carbol-
fuchsin stain. Rapid grow-
ers might not stain.Methylene blueMethylene bluePotassium per-
manganate or
acridine orangeCarbolfuchsinCarbolfuchsinAuramine- rhodamineAcid alcoholAcid alcoholAcid alcoholRed, slightly curved,
beaded rods (2–8 μm).
Blue background.Red, slightly curved,
beaded rods (2–8 μm).
Blue background.Yellow-orange rods
against dark background.