Acid-fast staining spectrum: Which organisms are demonstrable with acid-fast stains (Ziehl–Neelsen/Kinyoun), including partially acid-fast species?

Introduction / Context:
Acid-fast staining detects organisms with high lipid (mycolic acid) content in their cell walls. Recognizing the range—from fully acid-fast mycobacteria to partially acid-fast Nocardia—improves diagnostic accuracy for pulmonary and cutaneous infections.

Given Data / Assumptions:

• Methods include hot Ziehl–Neelsen and cold Kinyoun stains.
• Mycobacterium retain carbol fuchsin after strong acid-alcohol; Nocardia require weaker decolorizer.

Concept / Approach:
Mycobacterium tuberculosis and Mycobacterium leprae are strongly acid-fast. Nocardia are weakly acid-fast, retaining stain with mild acid (e.g., 0.5% sulphuric acid). Thus, all listed organisms can be demonstrated by acid-fast techniques with appropriate decolorization strength.

Step-by-Step Solution:
Apply carbol fuchsin with heat (ZN) or detergent (Kinyoun). Use suitable decolorizer strength: strong for Mycobacterium; weak for Nocardia. Counterstain and interpret red acid-fast bacilli/filaments.

Verification / Alternative check:
Parallel smears with differing decolorizers help distinguish strong versus partial acid-fastness, improving organism identification.

Why Other Options Are Wrong:

• Any single organism: Incomplete; all listed can be acid-fast stained under correct conditions.
• None of these: Contrary to standard microbiology practice.

Common Pitfalls:
Using an overly strong decolorizer for Nocardia may yield false negatives; always state decolorizer strength in the method.

Final Answer:
All of these organisms are demonstrable by acid-fast staining methods.