Lab Ex 3-7-Acid-Fast Stain
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Acid-Fast Stains B Theory The presence of mycolic acids in the cell walls of acid- fast organisms is the cytological basis for the acid-fast differential stain. Mycolic acid is a waxy substance that gives acid-fast cells a higher affinity for the primary stain and resistance to decolorization by an acid alcohol solution (3% HCl in 95% ethanol). A variety of acid-fast staining procedures are employed, two of which are the Ziehl-Neelsen (ZN) method and the Kinyoun (K) method. These differ primarily in that the ZN method uses heat as part of the staining process (this is in addition to heat-fixing the preparation), whereas the K method is a “cold” stain (which is still heat-fixed). In both protocols the bacterial smear may be prepared in a drop of serum to help the “slippery™ acid-fast cells (they are waxy, after all) adhere to the slide. The two methods provide comparable results and the choice of method comes down to lab conventions and personal preference. The waxy wall of acid-fast cells repels typical aqueous stains. As a result, most acid-fast positive organisms are only weakly Gram positive. The general sequence of events in an acid-fast stain are shown in Figure 3.59. In both the ZN and K methods, the phenolic compound carbolfuchsin is used as the primary stain because it is lipid soluble and penetrates the waxy cell wall. Staining by carbolfuchsin is further enhanced in the ZN method by steam heating the preparation to melt the wax and allow the stain to move into the wall. The K method compensates for not heating the smear by using a more concentrated and lipid-soluble carbolfuchsin solution as the primary stain. But as a consequence of not heating, the K method is slightly less sensitive than the ZN method. In both, acid alcohol is used to decolorize nonacid-fast cells; acid-fast cells resist this decolorization. A counterstain, such as methylene blue, then is applied. Acid-fast cells are reddish-purple, often with a beaded appearance; nonacid-fast cells are blue (Fig. 3.60). B Application The acid-fast stain is a differential stain used to detect cells capable of retaining a primary stain when treated with an acid alcohol. It is an important differential stain used to identify bacteria in the genus Mycobacterium, some of which are pathogens (e.g., M. leprae and M. tuberculosis, causative agents of leprosy and tuberculosis, respectively). Acid-Fast Acid-Fast Negative Cells prior to staining are transparent. After staining with carbolfuchsin, cells are reddish-purple. In the ZN stain, steam heat enhances the entry of carbolfuchsin into cells. In the K stain, a higher concentration of a more lipid-soluble carbolfuchsin is used to promote entry into the cells. o) N removes stain from acid-fast Decolorization with acid alcohol negative cells. is used to counterstain acid-fast Methylene blue or brilliant green negative cells. of 3.59 Acid-Fast Stain Overview of Both ZN and K Methods = Acid-fast cells stain reddish purple; acid-fast negative cells stain blue or the color of the counterstain if a different one is used. 3.60 Acid-Fast Stain Results = Notice how most of the Mycobacterium phlei (AF+) cells are in clumps, an unusual state for most rods. They do this because their waxy cell walls make them sticky. Try carefully and gently mixing them a little longer when preparing the slide than you would for other stains. A few individual cells are visible, however, and they clearly are rods that measure 0.5 by 2-3 um. The Staphylococcus epidermidis cells (AF—) are also in clumps, but that is because they grow as grapelike clusters. Each cell’s diameter is approxi- mately 1 um. Also notice the characteristic beaded appearance of some AF+ cells (circled). SECTION 3 Microscopy and Staining
Members of the actinomycete genus Nocardia (N. brasiliensis and N. asteroides are opportunistic pathogens) are partially acid-fast. Oocysts of coccidian parasites, such as Cryptosporidium and Isospora, are also acid-fast. Because so few organisms are acid-fast, the acid-fast stain is run only when infection by an acid-fast organism is suspected. Acid-fast stains are useful in identifying acid-fast bacilli (AFB) and in rapid, preliminary, and provisional diagnosis of tuberculosis (with greater than 90% predictive value from sputum samples). It also can be performed on patient samples to track the progress of antibiotic therapy and determine the degree of contagiousness. A prescribed number of microscopic fields are examined and the number of AFB is determined and reported using a standard scoring system. H In This Exercise Today you will perform an acid-fast stain designed primarily to identify members of the genus Mycobacte- rium. Because you know ahead of time which organisms should give a positive result and which should give a negative result, it is okay to mix them into a single emulsion. V¥ Materials Per Student 0 Lab coat 0 Disposable gloves 0 Acid-Fast Stain Using the ZN Method Per Student Group 0 Compound microscope with oil-immersion lens and ocular micrometer 0 Clean glass microscope slides O Staining tray 0 Staining screen 0 Bibulous paper or paper towel 0 Slide holder 0 Sterile wooden sticks or disposable plastic loops 0 Ziehl-Neelsen Stains (complete kits are commercially available) = Methylene blue stain = Ziehl’s carbolfuchsin stain = Acid alcohol (95% ethanol + 3% HCI) “ MICROBIOLOGY: Laboratory Theory & Application, Brief o Kinyoun Stains (complete kits are commercially available) = Kinyoun carbolfuchsin = Acid alcohol (95% ethanol + 3% HCI) = Methylene blue stain or brilliant green stain (some kits come with this counterstain) 0 Sheep serum 0 Squirt bottle with water 0 Heating apparatus (steam or hot plate)—for ZN only 0 Nonsterile Petri dish for transporting slides 0 Fresh agar slant cultures of these recommended organisms: = Mycobacterium phlei (BSL-2) or M. smegmatis (BSL-2) = Staphylococcus epidermidis s "> PROCEDURE Ziehl-Neelsen (ZN) Method 1 Wear a lab coat, gloves, and chemical eye protection when staining. Remove your gloves and eye protection when using the microscope. 2 Using BSL-2 precautions, prepare a smear of each organism on a clean glass slide as illustrated in Figure 3.41, substituting a drop of sheep serum for the drop of water. Gently mix the Mycobacterium smear thoroughly because the cells tend to stick together in clumps (Fig. 3.60), but use care not to produce aerosols. Air-dry and then heat-fix the smears using a microincinerator. Note: Because you know which organism is acid-fast positive and which is acid-fast negative, you may make two separate smears right next to one another on the slide or mix the two organisms in one smear. This is not recommended if you are staining an unknown. 3 Follow the staining protocol shown in the procedural diagram (Fig. 3.61). Use a steaming apparatus (such as the one in Fig. 3.62) to heat the slide. If the slide must be carried to and from the steaming apparatus, put it in a covered Petri dish. Caution! Be sure to have adequate ventilation (such as a fume hood or biosafety cabinet) while staining. 4 Observe using the oil-immersion lens. Record your observations of cell morphology and arrangement, dimensions, and acid-fast reaction in the table on the data sheet, page 199. 5 When finished, dispose of slides in a disinfectant jar or sharps container.
N PROCEDURE Kinyoun Method 1 Wear a lab coat, gloves, and chemical eye protection when staining. Remove your gloves and eye protection which is acid-fast negative, you may make two separate smears right next to one another on the slide or mix the two organisms in one smear. This is not recommended if you are staining an unknown. when using the microscope. 3 Follow the staining protocol shown in the procedural 2 Using BSL-2 precautions, prepare a smear of each diagram (Fi_g, 3:63): Caution] Be SULE 1oy Wear gloves, organism on a clean glass slide as illustrated in eye-pratsction, and perform the.stain with adequate Figure 3.41, substituting a drop of sheep serum for Zenti?;o:(;lifume o ar 2 bioareryabingr is the drop of water. Gently mix the Mycobacterium ccomme Ae . o A smear thoroughly because the cells tend to stick 4 Observe using the oil-immersion lens. Record your together in clumps (Fig. 3.60), but use care not to observations of cell morphology and arrangement, produce aerosols. Air-dry and then heat-fix the dimensions, and acid-fast reaction on the data sheet. m smears using a microincinerator. Note: Because you 5 When finished, dispose of slides in a disinfectant jar know which organism is acid-fast positive and or a sharps container. 4 7 1. Prepare a slide with up to three emulsions, each in a drop of serum (optional). Use a small inoculum and mix each smear thoroughly to separate the sticky mycobacterial cells, but — 2. Perform this step with adequate ventilation (e.g., in a fume hood). Wearing gloves and chemical eye protection, and the slide on the steaming apparatus, cover the smear(s) Staining Tray 3. Remove the bibulous paper (with forceps, if available, to keep the stain off your gloves) and dispose of it properly. Grasp the slide with a slide do not spatter (Fig. 3.41), and then heat-fix. Use BSL-2 precautions. Wearing gloves and eye protection, place the slide on the steaming apparatus (Fig. 3.62). If you need to transport the slide to another part of the lab for staining, put it in a covered Petri dish. with a strip of bibulous paper cut slightly smaller than the slide and apply ZN carbolfuchsin stain. Heat the slide to steaming for 5 minutes as shown in Figure 3.62. Keep the paper moist with stain and do not boil it. holder and hold it on an angle. Gently rinse both sides of the slide with distilled water into the staining tray. Staining Tray Staining Tray e Vv 6. If not already there, return to your lab station carrying the slide in a Petri dish. Then, place the slide on the staining tray and counterstain the smear(s) with methylene blue for 1 minute. Be sure the staining tray catches any excess stain. 4. Continue holding the slide with a slide holder. Decolorize with acid-alcohol until the runoff s clear. Use caution when handling the acid-alcohol. 5. Still holding the slide on an angle, gently rinse with distilled water into a staining tray. < _/ T -1 L Staining Tray “ '—/t 3.61 Procedural Diagram: ZN Acid-Fast Stain = Use BSL-2 precautions throughout this procedure and perform the staining in a fume hood or well-ventilated area. Carry the slide to and from the steaming apparatus in a covered Petri dish. 7. Grasp the slide with a slide holder and hold it on an angle. Gently rinse the slide with distilled water into the staining tray. 8. Gently blot dry in a tablet of bibulous paper or paper towels. (Alternatively, a page from the tablet can be removed and used for blotting.) Do not rub. When dry, observe under oil immersion. SECTION 3 Microscopy and Staining “ N
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