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Journal of Clinical Microbiology, August 2002, p. 2791-2794, Vol. 40, No. 8
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.8.2791-2794.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Utility of Gram Staining for Evaluation of the Quality of Cystic Fibrosis Sputum Samples

Bindu Nair,1 Jenny Stapp,2 Lynn Stapp,2 Linda Bugni,2 Jill Van Dalfsen,3 and Jane L. Burns1,2*

Division of Infectious Disease, Department of Pediatrics, University of Washington,1 Cystic Fibrosis Foundation Therapeutic Development Network Core Microbiology Laboratory,2 Chiron Corporation, Seattle, Washington3

Received 28 December 2001/ Returned for modification 18 March 2002/ Accepted 12 May 2002

The microscopic examination of Gram-stained sputum specimens is very helpful in the evaluation of patients with community-acquired pneumonia and has also been recommended for use in cystic fibrosis (CF) patients. This study was undertaken to evaluate that recommendation. One hundred one sputum samples from CF patients were cultured for gram-negative bacilli and examined by Gram staining for both sputum adequacy (using the quality [Q] score) and bacterial morphology. Subjective evaluation of adequacy was also performed and categorized. Based on Q score evaluation, 41% of the samples would have been rejected despite a subjective appearance of purulence. Only three of these rejected samples were culture negative for gram-negative CF pathogens. Correlation between culture results and quantitative Gram stain examination was also poor. These data suggest that subjective evaluation combined with comprehensive bacteriology is superior to Gram staining in identifying pathogens in CF sputum.

* Corresponding author. Mailing address: Division of Infectious Disease, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, CH-32, Seattle, WA 98015. Phone: (206) 526-2073. Fax: (206) 527-3890. E-mail: jburns{at}chmc.org.

Journal of Clinical Microbiology, August 2002, p. 2791-2794, Vol. 40, No. 8
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.8.2791-2794.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.





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