Health Library

Acid-fast stain

The acid-fast stain is a lab test that determines if a sample of tissue, blood, or other body substance is infected with the bacteria that cause tuberculosis (TB) and other illnesses.

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How the Test is Performed

Depending on where the infection may be in your body, your health care provider will collect one of these samples:

• Urine
• Stool
• Sputum
• Bone marrow
• Tissue

The sample is then sent to a lab. Some of the sample is placed on a glass slide, stained, and heated. The cells in the sample hold onto the dye. The slide is then washed with an acid solution and a different stain is applied.

Bacteria that hold onto the first dye are considered "acid-fast" because they resist the acid wash. These types of bacteria are associated with TB and other infections.

How to Prepare for the Test

The preparation depends on how the sample is collected. Your provider will tell you how to prepare.

How the Test will Feel

How much discomfort you may feel depends on how the sample is collected. Your provider will discuss this with you.

Why the Test is Performed

The test can tell if you are likely infected with the bacteria that cause TB and related infections.

Normal Results

A normal result means no acid-fast bacteria were found on the stained sample.

Normal value ranges may vary slightly among different labs. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test result.

What Abnormal Results Mean

Abnormal results may be due to:

• TB
• Leprosy
• Nocardia infections (also caused by a bacteria)

Risks

Risks depend on how the sample is collected. Ask your provider to explain the risks and benefits of the medical procedure.

References

Bailey TC, Philips JA. Tuberculosis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 299.

Huaman MA, Sterling TR, Haas DW. Mycobacterium tuberculosis. In: Blaser MJ, Cohen JI, Holland SM, et al, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 10th ed. Philadelphia, PA: Elsevier; 2026:chap 255.

Rodino KG, Woods GL, Wengenack NL. Mycobacteria. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 59.

Review Date: 12/13/2025  

Reviewed By: Jatin M. Vyas, MD, PhD, Roy and Diana Vagelos Professor in Medicine, Columbia University Vagelos College of Physicians and Surgeons, Division of Infectious Diseases, Department of Medicine, New York, NY. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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