Evaluation of Gram Stain Error Rates of Clinical Specimens

  • Rabia Sajjad Combined Military Hospital, Attock/National University of Medical Sciences (NUMS) Pakistan
  • Gohar Zaman KRL Hospital, Islamabad Pakistan
  • Irfan Ali Mirza Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Wajid Hussain Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Umar Khurshid Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Asim Shehzad Fauji Foundation Hospital, Rawalpindi Pakistan
Keywords: Clinical specimens, Errors, Gram stain

Abstract

Objective: To determine important errors in initial Gram staining of clinical specimens and evaluate the types of Gram-stain errors.

Study Design: Cross-sectional study.

Place and Duration of Study: Microbiology Department, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Aug 2018 to Feb 2019.

Methodology: Gram staining and culture inoculation of all specimens were performed per recommended guidelines. The Gram stain results on day-0 were compared with the results of the culture on day-2. There was no discrepancy if similar organisms were obtained on culture as on Gram stain. Nevertheless, if the Gram stain and culture results were not similar, it was termed a discrepancy. The consultant microbiologist reviewed all discrepant slides, and if not resolved, possible causes of error were sought, and the results documented.

Results: Of the total 300 clinical specimens, errors were observed in the initial gram staining of 29 specimens (9.7%), whereas 271(90.3%) specimens were error-free. Upon evaluating these 29 errors, 11(38.0%) were observer errors which were resolved when reviewed by a consultant microbiologist. 14(48.0%) were technical errors, and 4(14.0%) results were discrepant due to the presence of anaerobic organisms, missed on initial aerobic cultures.

Conclusion: The frequency of Gram stain errors in our study (9.7%) is not very high; nevertheless, it can have severe consequences in critical samples from seriously ill patients if wrong empirical antimicrobial treatment is begun based on a wrong initial Gram stain result.

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Published
2022-12-29
How to Cite
Sajjad, R., Zaman, G., Mirza, I., Hussain, W., Khurshid, U., & Shehzad, A. (2022). Evaluation of Gram Stain Error Rates of Clinical Specimens. Pakistan Armed Forces Medical Journal, 72(6), 1945-48. https://doi.org/10.51253/pafmj.v72i6.5815
Section
Original Articles

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