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Bacteriology

Gram Staining: a Comparison of Two Automated Systems and Manual Staining

Neele J. Froböse, Sara Bjedov, Franziska Schuler, Barbara C. Kahl, Stefanie Kampmeier, Frieder Schaumburg
Nathan A. Ledeboer, Editor
Neele J. Froböse
aInstitute of Medical Microbiology, University Hospital Münster, Münster, Germany
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Sara Bjedov
aInstitute of Medical Microbiology, University Hospital Münster, Münster, Germany
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Franziska Schuler
aInstitute of Medical Microbiology, University Hospital Münster, Münster, Germany
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Barbara C. Kahl
aInstitute of Medical Microbiology, University Hospital Münster, Münster, Germany
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Stefanie Kampmeier
bInstitute of Hygiene, University Hospital Münster, Münster, Germany
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Frieder Schaumburg
aInstitute of Medical Microbiology, University Hospital Münster, Münster, Germany
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Nathan A. Ledeboer
Medical College of Wisconsin
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DOI: 10.1128/JCM.01914-20
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ABSTRACT

Various Gram staining automated systems are available to accelerate and standardize the staining process, but a systematic comparison of different systems is largely lacking. The objective of this study was to evaluate two devices in comparison to manual Gram staining. Clinical samples (n = 500; University Hospital Münster, Germany; May to June 2020) were simultaneously Gram stained manually and with two automated Gram stainers (Previ Color Gram, bioMérieux, and ColorAX2, Axonlab). The quality was assessed based on four criteria: (i) homogeneous staining of bacteria/fungi, (ii) uniform staining of the background, (iii) absence of staining artifacts, and (iv) congruency between culture and microscopy. Each criterion was rated with 0 (absence) or 1 (presence) point to calculate a quality score (0 to 4 points). The costs for each staining procedure were calculated based on consumables and hands-on time (applying the average wage of a laboratory technician in the public service for Germany and the United States). The mean (± standard deviation [SD]) quality scores were comparable for manual staining (3.06 ± 0.91) and Previ Color Gram (3.04 ± 0.90; P = 0.6), while significantly lower scores were achieved by ColorAX2 (2.57 ± 1.09; P < 0.0001). The total cost per Gram stain was €1.13/$1.34 for Previ Color Gram, €0.80/$0.83 for manual, and €0.60/$0.71 for ColorAX2, respectively. The quality and costs per slide vary significantly between instruments of different manufacturers.

FOOTNOTES

    • Received 23 July 2020.
    • Returned for modification 24 August 2020.
    • Accepted 9 September 2020.
    • Accepted manuscript posted online 16 September 2020.
  • Supplemental material is available online only.

  • Copyright © 2020 American Society for Microbiology.

All Rights Reserved.

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Gram Staining: a Comparison of Two Automated Systems and Manual Staining
Neele J. Froböse, Sara Bjedov, Franziska Schuler, Barbara C. Kahl, Stefanie Kampmeier, Frieder Schaumburg
Journal of Clinical Microbiology Nov 2020, 58 (12) e01914-20; DOI: 10.1128/JCM.01914-20

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Gram Staining: a Comparison of Two Automated Systems and Manual Staining
Neele J. Froböse, Sara Bjedov, Franziska Schuler, Barbara C. Kahl, Stefanie Kampmeier, Frieder Schaumburg
Journal of Clinical Microbiology Nov 2020, 58 (12) e01914-20; DOI: 10.1128/JCM.01914-20
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KEYWORDS

Coloring Agents
automated systems
microscopy
Gram stain

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