G121

Gram – Wound: gram negative bacilli, no cells present – Shipped May 2012

HISTORY

A smear simulating a thigh wound collected from a 30 year old female burn patient was sent to category A, B, C, and C1 laboratories for Gram staining.

Participants were expected to report the presence of gram negative bacilli. There were no cells in the sample. Correlation with results obtained for the companion culture, M121-3 was also expected from labs that received the culture.

MAIN EDUCATIONAL POINTS from G121

  1. Along with clinical symptoms, a properly prepared, stained, read and reported Gram stain will provide information to aid the clinician in distinguishing between colonization and infection of burn wounds.
  2. It is important to accurately report the presence (or absence) of PMNs and their amounts, as well as the presence or absence of bacteria, their amounts and the number of morphotypes. As mentioned in critique G114, there is a significant difference between reporting 1+ and 2-4+ PMNs and incorrect reporting can lead to inappropriate and/or unnecessary treatment for the patient.

 

Full critique (PDF)

Posted in Clinical Bacteriology Results, critiques, Gram