J Korean Orthop Assoc.  1974 Mar;9(1):91-95. 10.4055/jkoa.1974.9.1.91.

The N.B.T. Dye Reduction Test in Orthopedic Infections

• Lee SH
• Park KY
• Hahn MS
• Choi YH
• Kim SI

• KMID: 2471604
• DOI: http://doi.org/10.4055/jkoa.1974.9.1.91

Abstract

By various enzymatic activities, colorless Nitroblue-Tetrazolium salts are reduced to form Formarans which can easily be recognized as dark blue deposits. Bacterial presence in circulating blood could induce metabolic changes in neutrophils those are sufficient to cause spontaneous in-vitro reduction of N.B.T. dye. Increased proportion of Formasan-containing neutrophils in their cytoplasm (NBT-positive neutrophil) would be observed in the course of natural infection if the involved individual has normal phagocytic activity. It is the very hypothesis from which Park et al (1968) devised a new supravital staining technique (NBT test) to differentiate patients with bacterial infection from without. Present study was undertaken to appreciate the clinical usefulness of this test by practical application on 54 in-patients in Department of Orthopedic Surgery, Seoul National University Hospital during the period from May 1 to July 31, 1973. The following observations were obtained; 1. A significant increase of Percentage of NBT (+) neutrophils was notified in pyogenic ostenye litis to 23.6±8.2% (M±SD) for acute and 16.5±12.8% for chronic respectively, when compared to normal healthy controls which were 5.53±4.60% for male and 4.25±4.04% for female. 2. A remarkable increase to 40.3±16.9% was notified in fresh tuberculosis of bone and joint, whereas old tuberculosis remained in quite normal range by 5.0±2.8%. 3. A meaningful increase to 19.0±9.9% was notified also for soft tissue infections. 4. Non-infectious diseases, orthopedical, did show minimal increase to 10.2±3.7% which was proved to be negligible by bio-statistical treatment. 5. With respects to above result, the NBT test could darely be said to be a new, simple and reliable test also for orthopedic infectious conditions.

MeSH Terms

Bacterial Infections
Cytoplasm
Female
Humans
Joints
Male
Neutrophils
Orthopedics*
Reference Values
Salts
Seoul
Soft Tissue Infections
Tuberculosis
Salts

Figure

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  Fig. 1. Microphotograph showing two typical NBT positive neurophils with dense blue-black deposits of formazan. (×100)

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  Fig. 2. A NET positive neutrophil with a dot of formazan. (×1000, emulsion oil)

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  Fig. 3. A NET positive neutrophil with a large diffuse deposit of formazan. (×1000)

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  Fig. 4. A monocyte with a formazan deposit. not counted as positive cells. (×1000)

Reference

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