Re: B&B Gram problem

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Jeanine Bartlett at the Centers for Disease Control in Atlanta GA raises a 
technical question about the Brown and Brenn Gram stain. I have no useful 
advice, but I'd like to put a pathologist's question about the stain into 
this public forum - would like to know what people at the CDC think about it.

Tissue Gram stains are kind of a reflex order when infection is suspected, 
but they don't make much sense. One is trying to find bacteria, and the stain 
is not a good one for finding Gram negative bacteria. If one is just trying 
to find bacteria, a Giemsa stain (or a simplification of the Giemsa stain 
such as buffered toluidine blue) is considerably more sensitive, and about as 
specific if you keep your wits about you.

For this reason, I almost never order a tissue Gram stain unless I'm required 

Bob Richmond
Samurai Pathologist
Knoxville TN

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