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Treatment of Mycobacterium Abscessus

MAC & Bronchiectasis | Last Active: Jun 5, 2023 | Replies (11)

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@marthamac

The AFB smear is the first look a lab takes at a sputum sample being tested for TB or NTM. TB and NTM are acid fast bacteria (AFB). A thin layer of the sputum sample is smeared on a slide and then colored with a dye that is taken up by the bacteria. Then the slide is treated with an acid which bleaches out most of the bacteria. The ones that hold the color are “acid-fast” and are the TB and NTM. When the smear is reported as positive, usually with the number of organisms seen on a high power field, it means the bacterial load is relatively high. When the smear is negative, it typically means the bacterial load is lower, although there may still be enough for a positive culture. The lab can’t tell from a positive smear which specific organism you have. That can only be determined when a large enough quantity of the bacteria have grown in the culture.

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Replies to "The AFB smear is the first look a lab takes at a sputum sample being tested..."

@susiellen Martha that is very good info. One thing I might add is to make sure there is an antibiotic Susceptibility testing being done on the sample if positive on the culture, which in
Susiellen's case is very likely. Not all labs are set up to do this, and some doctors will just not order it even if available. I would call and make sure that test is being done. Bill

Thank you, Martha. That helps a lot and is what I was looking for (higher load).
From the very short email from my pulmonologist, the positive AF smear means she would like to start treatment. I have to wait for the culture, then she will set me up for a consultation with an ID doc.