Gram Stain, Fairview Range


Sunquest Code:GRAM  
Epic Code:LAB250  
Synonyms:Bacterial Smear
Methodology:Gram Stain
Test Includes:Microscopic exam of Gram stained specimen. Preliminary review performed on all STAT requests and all CSF, subdural fluid, and subarachnoid fluid  at prior to sending to UMMC-East Infectious Diseases Diagnostic Laboratory (IDDL).
Turnaround Time:Performed 24 hours/day; results are reported in approximately 4 hours for routine testing, and 30-60 minutes for STAT testing.
Special Instructions:Indicate specimen site on request form.


Collection Instructions

Specimen:Fluid, tissue, aspirate, respiratory (sputum and bronchial) and swabbed anatomical sites.
Fluid, tissue and aspirate is always preferred over swab, when possible.
Automatically performed on :CSF, subdural fluid, subarachnoid fluid, sputum (expectorated), and vaginal. Other specimen types require a specific request.
Optimal Volume:3 mL fluid or aspirate.
Minimum\Peds Volume:0.5 fluid or aspirate. Tissue must be visible.
Container:Plastic leakproof container, sterile (Culturette swab, See Collection Instructions)
Collection Instructions:Sterile conteiner:
Fluid Optimal volume: 3 mL
Minimum volume: 0.5 mL
Tissue Optimal: visible tissue
Aspirate Minimum volume: 0.5 mL
Bronchial Optimal volume: 2 mL
Minimun volume: 0.5 mL
  Any swabbed anatomical site (i.e. superficial wound, vagina
for Bacterial Vaginosis, etc.)
  Never use fluid tissue, aaspirate or lower respiratory collections.
 
Causes for Rejection:Not an adequately sensitive test on direct blood films; not useful on throat or fecal specimens except to screen for overgrowth of yeast. Gram stain may not be possible on hard bone specimens or foreign bodies (i.e. catheter tips) without the presence of soft tissue or purulent material. Testing on these specimens may be canceled at laboratory's discretion.


Processing and Shipping

Specimen Processing:Store at room temperature.
Shipping Instructions:Ship slides at room temperture i protective slide holder. If a culture is also requested, laboratory will use the original specimen to prepare a smear and a separate slide is not required.
Test Performed at or Referral Lab Microbiology  (Fairview Range - FRMC)


Interpretive

Reference Range:No organisms seen
Use:Provides preliminary information regarding presence or absence of bacteria, yeast, neutrophils, epithelial cells, pathogenic organisms, anaerobic organisms. Sensitivity of culture is significantly higher as compared to gram stain alone. Culture also allows antibacterial susceptibility testing of pathogenic organisms. It is recommened to order appropriate culture in conjunction with gram stain. Diagnosis of bacterial vaginosis does not require a culture. May be helpful for diagnosis of moniliasis (thrush)


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