ArticleJournal of clinical microbiology2007
First notification of positive blood cultures and the high accuracy of the gram stain report.
Article in Journal of clinical microbiology, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Comparison of Gram stain interpretation accuracy between a computer-aided diagnosis app and microbiology specialists in blood culture samples.Microbiology spectrum · 2026Observational
- From Gram Stain to Decision Support: Performance of Multimodal Large Language Models in Blood Culture Microscopy.Journal of imaging informatics in medicine · 2026Article
- A mathematical model to estimate the probability of blood cultures positive for pyogenic streptococci.Le infezioni in medicina · 2025Article
- Performance evaluation of machine-assisted interpretation of Gram stains from positive blood cultures.Journal of clinical microbiology · 2024Article
- Aerobic Vaginitis Diagnosis Criteria Combining Gram Stain with Clinical Features: An Establishment and Prospective Validation Study.Diagnostics (Basel, Switzerland) · 2022Article
- Evaluation of the Performance of Direct Susceptibility Test by VITEK-2 from Positively Flagged Blood Culture Broth for Gram-Negative Bacilli.Journal of laboratory physicians · 2021Article
- Bronchoalveolar Lavage Gram Stains for Early Bacterial Identification in Pneumonia: Should They Stay or Should They Go?Critical care explorations · 2021Article
- Scanning Electron Microscope: A New Potential Tool to Replace Gram Staining for Microbe Identification in Blood Cultures.Microorganisms · 2021Article
- Automated Interpretation of Blood Culture Gram Stains by Use of a Deep Convolutional Neural Network.Journal of clinical microbiology · 2018Article
- Waltzing around Sacred Cows on the Way to the Future.Journal of clinical microbiology · 2018Article
- Multicenter Assessment of Gram Stain Error Rates.Journal of clinical microbiology · 2016Article
- Limitations of Gram staining for the diagnosis of infections following total hip or knee arthroplasty.Experimental and therapeutic medicine · 2015Article
- Rapid intrinsic fluorescence method for direct identification of pathogens in blood cultures.mBio · 2013Article
- Predominance of Enterobacteriaceae isolates in early positive anaerobic blood culture bottles in BacT/Alert system.Journal of clinical laboratory analysis · 2013Article
- Blood culture status and mortality among patients with suspected community-acquired bacteremia: a population-based cohort study.BMC infectious diseases · 2011Article
- Evaluation of the alkaline wash/lysis procedure for the molecular diagnosis of a positive bacterial blood culture in clinical routine practice.Journal of clinical laboratory analysis · 2010Article
- Rapid identification of methicillin-resistant staphylococci bacteremia among intensive care unit patients.Medscape journal of medicine · 2008Article
- Evaluation of performance of direct disk diffusion test from positively flagged blood culture broth: A large scale study from South India.Journal of laboratory physiciansArticle
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
When blood cultures turn positive, the attending physicians are usually notified immediately about Gram stain findings. However, information on the accuracy of Gram staining is very limited. We examined the accuracy of preliminary blood culture reports provided by a regional laboratory in an observational study including the years 1996, 2000 to 2001, and 2003. We used data from computer files and technicians' laboratory notes. The study was restricted to cultures with one morphological type. Using cultural identification as a reference, we estimated the sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) for the following defined morphological groups: gram-positive cocci in clusters, gram-positive cocci in chains or diplococci, gram-positive rods, gram-negative cocci, gram-negative rods, and yeasts. We further evaluated the Gram stain and wet mount findings for the most frequent bacterial species/groups. We obtained 5,893 positive blood cultures and the following results for the defined groups: sensitivity, range of 91.3 to 99.7%; specificity, 98.9 to 100%; PPV, 94.6 to 100%; and NPV, 99.0 to 100%. The sensitivity for the most frequent species was in the range 91.3 to 100%, with nonhemolytic streptococci having the lowest value (sensitivity, 91.3%; 95% confidence interval, 86.2 to 94.9%). Wet mount reports were less accurate (sensitivity of 30 to 70% for species with peritrichous motility), and Enterobacteriaceae (notably Salmonella spp.) accounted for 25% of the reports stating polar motility. In conclusion, we demonstrated a high accuracy of Gram stain reports, whereas wet mount microscopy was generally less accurate.
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