Gram’s stain joy

One of the most useful ‘tests’ in clinical microbiology is the Gram’s stain named after Hans Christian Gram from Copenhagen, Denmark.

This differential staining technique is one of the most important things we do in the clinical microbiology laboratory.

Unfortunately because of newer technology, e.g., fancy chromogenic media, latex agglutination, MALDI-TOF and nucleic acid amplification assays simple things like a wet preparation and a Gram’s stain are being done less often. A “wet prep” and a “Gram” are quick and easy and tell you so much about what is growing on a plate. That said, the newer technologies are ‘must haves’ in any modern clinical microbiology laboratory. I am so impressed with the value of the MALDI-TOF.

Last week I started with seeing a Gram’s stain consistent with Vincent’s angina and finished the day seeing gonococci in a female genital specimen from a patient with an interesting clinical history. I smiled all night thinking about how cool my day was.

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2 thoughts on “Gram’s stain joy

  1. Sorry about my late reply with this Gary. My biggest problem with the technology such as the MALDI-TOF coming into labs is the effect it has on smaller labs and the push to centralise microbiology services. As I understand, the cost of running an ID via MALDI-TOF is nothing in contrast to traditional biochemical testing/API/Vitek etc. One classic example I can provide right now is the turn around for blood cultures that we try to achieve here at my workplace. With the right people clued in, we can have a blood culture go from machine positive to final report in less than 24hrs. It probably doesn’t change the outcome, but it is very much about providing the best possible service. Compare that sort of timeframe (assuming a machine positive time of 14hrs from time of loading) to sending to a central location from a regional part of Australia – in theory, by the time a BC flags positive in the regional location, it might only just end up being loaded onto the automated instrument with no hope of catching up.

    I applaud the MALDI-TOF for how quick it can give a result, but I hope it doesn’t see microbiology die in the remote and regional locations. Microbiology is the last bastion of joy that my job as a scientist provides due in part to its labour intensiveness, and the feeling of being a scientist once more and asking what and why.

    • Hi Josh. I don’t disagree. I’m enamoured by the MALDI-TOF by the speed and cost of around 8 cents a go. It still needs culture though. I’m in a discussion at the moment with colleagues around whole genome sequencing and the future of microbiology. I have my happiest moment when sitting at a bench, holding a plate, sniffing the growth and knowing what is there by sight and smell. Nothing will ever beat that.

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