Sepsis Research Today is a free monthly online journal that collates and summarizes the latest research about Sepsis, including details on septicemia, diagnosis, symptoms, treatment.

Errors in interpretation of Gram stains from positive blood cultures.

Rand KH, Tillan M

Department of Pathology, Division of Infectious Disease, University of Florida, Gainesville, FL 32610, USA.

We reviewed major errors in Gram stain reports from positive blood cultures to identify patterns and potential clinical impact. During a 23-month period, blood cultures were misread for 57 (0.7%) of 8,253 patients. Of 5,885 read as gram-positive cocci, 6 (0.1%) had only gram-negative organisms by culture, 3 of which were Acinetobacter species Of 1,959 read as gram-negative bacilli, 25 (1.3%) had only gram-positive organisms by culture. Of these, 9 were Bacillus and 2 were Clostridium species. Nonrecognition of mixed Gram stains accounted for 28 errors that most often were associated with a reading of gram-positive cocci. In 4 cases, there were delays of 14 hours to 3 days in starting appropriate antibiotic treatment; 2 deaths occurred, although the erroneous Gram stain report probably was not contributory. Pathologists and laboratory personnel need to be aware of these types of misinterpretations and the potential effects on patient outcome.

Published 19 October 2006 in Am J Clin Pathol, 126(5): 686-90.
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