改良革兰染色法在显示石蜡切片真菌中的应用

目的建立真菌的病理切片改良革兰染色法。方法选取确诊真菌感染的组织蜡块,切若干空白片,通过苏木素-伊红染色（HE）、高碘酸-无色品红染色（PAS）、六胺银染色（GMS）、改良革兰染色后,比较改良革兰染色法的染色效果。结果改良革兰染色法的染色效果好,该法具有易操作、染色效果稳定等优点。结论改良革兰染色法能够清晰地显示出组织切片中的真菌,并且染色效果稳定,在检测组织中的真菌时可发挥重要的辅助诊断价值,具有广泛的应用前景。     

巴尔通体分离培养特性观察

从鼠类血液中分离巴尔通体(Bartonella),观察其分离培养特性。被检鼠血为2004年收集自云南省的4个县,采用含5%去纤维兔血脑心浸液琼脂培基置于35℃含5%CO2培养箱中分离培养巴尔通体,进行观察,涂片革兰染色镜检,疑似菌落用巴尔通体属特异性引物进行聚合酶链反应(PCR)扩增特异基因片段[枸橼酸合酶基因(gltA)的379 bp片段],电泳图中出现目标带即判断为阳性菌株。从397份鼠血分离到巴尔通体47份,分离率为11.8%。阳性菌落长出时间最早为3 d,多数为1~2周,占70.2%(33/47)。阳性菌落形态随培养时间延长而改变,特点多样。PCR阳性的菌经革兰染色,镜下均可见革兰阴性小杆菌。结果可见,可先用涂片革兰染色镜检,对疑似菌落进行初筛,巴尔通体种类多、形态多样,培养时间延长,菌落形态可能发生变异,有待进一步探索。     

三种方法检测淋球菌的结果分析

用革兰染色、淋球菌培养、PCR检测三种方法同时对135例泌尿生殖道患者进行淋球菌检测.革兰染色阳性53例,检出率39.26%,淋球菌培养68例,检出率50.37%,PCR阳性78例,检出率57.78%.上述结果经统计学处理x2=9.39,P＜0.05.革兰染色与淋球菌培养和PCR检测有差异,淋球菌培养与PCR检测P＞0.05,二种方法差异无显著性,其中,用PCR法测淋球菌敏感、特异、快速.提示临床上在革兰染色、淋球菌培养均阴性而症状又符合淋球菌感染者考虑可用PCR方法检测.这对淋病患者进行准确地早期发现,早期诊断和防治及因淋球菌漏检而引起的淋病传播起到重要作用.     

临床微生物检验的数字化和自动化

传统的病原微生物鉴定方法首先是进行革兰染色,以区分革兰阴性菌还是阳性菌.革兰阴性杆菌进一步做氧化酶试验,革兰阳性球菌做触酶试验和凝固酶试验,再按不同类型进行生化学和血清学鉴定.     

5 600例白带涂片镜检结果分析

目的：探讨线索细胞在白带清洁度划分的作用。方法：常规采样,新鲜标本分别用湿片法和革兰染色检查,以革兰染色检出为标准判断湿片中微生物检出及白带清洁度划分的准确性和可靠性。结果：湿片法对线索细胞的误辩率较高,清洁度划分难把握。结论：湿片法和革兰染色法两者相结合可较好地划分白带清洁度,明确阻道炎的性质。     

耐60℃高温乳酸菌的驯化及鉴定

目的对本实验室保存的ATCC 4356菌株进行温度梯度诱变,从而获得1株耐高温乳酸菌。方法采用温度梯度方法诱变菌株;通过革兰染色和原子力显微镜观察诱变前后菌株革兰染色特性和形态及表面结构的变化;通过生理生化特性鉴定,判断诱变前后菌株是否发生种属变化。结果在45~60℃诱变过程中,随温度升高传代次数递增,但最终均能成功驯化和稳定传代。驯化前后菌株在产酸能力、形态特征、革兰染色和生理生化特性方面无显著性变化,表明该诱导菌株未发生种属变化;原子力显微镜观察结果表明诱导前后菌株表面形态存在差异。结论温度梯度诱变技术能够成功驯化耐60℃高温乳酸菌,从而扩大其应用范围。     

A型产气荚膜梭菌经小鼠传代的毒力变化

目的:探讨A型产气荚膜梭菌经小鼠腹腔传代后的毒力变化。方法:选择10只小鼠,腹腔注射浓度为5.0×108 cfu/mL的A型产气荚膜梭菌菌液1 mL,记录第一代小鼠存活时间;收集第一代死亡最早的小鼠腹腔内的细菌,经血平板厌氧培养24 h后配制5.0×108 cfu/mL浓度的菌液,并腹腔注射10只小鼠,每只1 mL,记录第二代小鼠存活时间;重复实验并记录第三代、第四代小鼠的存活时间;死亡小鼠腹腔收集的细菌以革兰染色涂片镜检,血平板培养,用API 20A试剂条进行生化鉴定;用SPSS 13.0软件分析每代小鼠的存活时间组间差异。结果:小鼠腹腔收集的标本经革兰染色后均可见两端钝圆棒状的革兰阳性杆菌,血平板厌氧培养均为边缘呈锯齿状有双溶血环的较大菌落,API 20A的结果为产气荚膜梭菌;小鼠存活时间随小鼠腹腔传代数不断延长,第一代与第二代、第三代、第四代之间的存活时间差异有统计学意义,第二代、第三代与第四代两两之间的存活时间差异无统计学差异。结论:A型产气荚膜梭菌经小鼠腹腔第一次传代后毒力显著减弱,随后传代中毒力基本不变,与传统的细菌经动物腹腔培养后毒力增强的观点不一致。     

BV三联法在细菌性阴道病诊断中的应用与评价

目的探讨BV三联法在诊断细菌性阴道病中的临床价值方法用BV三联法（检测患者阴道分泌物中的过氧化氢浓度、唾液酸苷酶、白细胞脂酶）和Amsel法（检测阴道分泌物并对阴道分泌物进行涂片革兰染色镜检）。结果BV三联法与Amsel法结合涂片革兰染色结果差异无显著性（P〈0．05）。结论BV三联法是一种新型、简便、快速的方法,可用于临床辅助诊断细菌性阴道病。     

同株奇异变形杆菌存在不同生长状态

揭示同株奇异变形杆菌存在多种不同的生长状态。通过环形接种、点种传代、革兰染色和鞭毛染色等方法观察同株奇异变形杆菌的形态学变化。同株奇异变形杆菌的生长速度、迁徙能力、生长形态及鞭毛形态发生变化。同株奇异变形杆菌存在不同的生长形态。     

出生24小时内女婴阴道分泌物乳杆菌的研究

目的了解出生后24h内女婴阴道分泌物的乳杆菌带菌状态。方法选取2011年8月至2011年12月在北京大学第一医院足月分娩的女婴,剖宫产和阴道分娩的足月女婴各30例,剖宫产中胎膜早破22例,宫内感染2例;阴道分娩中胎膜早破18例,宫内感染9例,于出生后24h内取女婴阴道分泌物,分别行涂片革兰染色镜检及提取DNA使用乳杆菌属特异性引物行PCR扩增,分析阴道菌群状况。结果所有样本涂片行革兰染色镜检均未见革兰阳性杆菌,提取DNA行PCR扩增,均未见到明显条带。结论生后24h的女婴阴道分泌物为无乳杆菌状态。     

Effect of heat-staining procedure on the gram staining properties of mycobacteria]

Since the establishment of Gram stain by H.C.Y. Gram in 1884, it has been widely and routinely used as an aid for differentiation of bacteria. The bacteria are divided into three categories by the staining properties; Gram-positive, -negative, and -indefinite. All the text books in the world describe that mycobacteria such as M. tuberculosis are Gram-positive. By the merest chance, however, it was found that M. lepraemurium grown in tissues was not stained by the routinely used Gram staining method. Therefore, we tried to stain some of the mycobacteria by the Gram staining procedure which is widely used at present. The results obtained indicated that the mycobacteria tested were divided into three groups; the unstainable group such as M. leprae and M. lepraemurium, the Gram-positive and difficult-to-stain group which involves such slow growing mycobacteria as M. tuberculosis, M. avium, and M. intracellulare, and the Gram-indefinite group which contains such rapid growing mycobacteria as M. phlei, M. smegmatis, and M. chelonae. However, if Gram stain is carried out by the heating procedure at the first staining step, all the mycobacteria would become Gram-positive. Therefore, we emphasize that Gram staining of mycobacteria should be performed by the heating procedure.     

革兰氏染色三步法与质量控制

革兰氏染色(Gram stain),是细菌学中一个经常使用和十分重要的方法,自从1884年微生物学家Gram氏发明著名的革兰氏染色法以后,100多年来虽然经过后来学者的几次改进,但都仍然沿用着Gram氏原来的四步法,基本原理也没有改变。最近Allen氏对Ziehl-Neelsen抗酸菌染色法的改进,是一个良好的启示,使我们开始了革兰氏染色三步法的研究并取得了成功。现将我们建立的革兰氏染色三步法与质量控制报告如下。 1 材料和方法 1.1 结晶紫染色液 甲液:结晶紫2g;95％乙醇20ml。 乙液:草酸铵0.8g;蒸馏水80ml。 甲乙二液先分别溶解,然后混合在一起,过滤除去残渣后装入滴瓶中备用。     

Mechanism of gram variability in select bacteria.

Gram stains were performed on strains of Actinomyces bovis, Actinomyces viscosus, Arthrobacter globiformis, Bacillus brevis, Butyrivibrio fibrisolvens, Clostridium tetani, Clostridium thermosaccharolyticum, Corynebacterium parvum, Mycobacterium phlei, and Propionibacterium acnes, using a modified Gram regimen that allowed the staining process to be observed by electron microscopy (J. A. Davies, G. K. Anderson, T. J. Beveridge, and H. C. Clark, J. Bacteriol. 156:837-845, 1983). Furthermore, since a platinum salt replaced the iodine mordant of the Gram stain, energy-dispersive X-ray spectroscopy could evaluate the stain intensity and location by monitoring the platinum signal. These gram-variable bacteria could be split into two groups on the basis of their staining responses. In the Actinomyces-Arthrobacter-Corynebacterium-Mycobacterium-Propionibacterium group, few cells became gram negative until the exponential growth phase; by mid-exponential phase, 10 to 30% of the cells were gram negative. The cells that became gram negative were a select population of the culture, had initiated septum formation, and were more fragile to the stress of the Gram stain at the division site. As cultures aged to stationary phase, there was a relatively slight increase toward gram negativity (now 15 to 40%) due to the increased lysis of nondividing cells by means of lesions in the side walls; these cells maintained their rod shape but stained gram negative. Those in the Bacillus-Butyrivibrio-Clostridium group also became gram negative as cultures aged but by a separate set of events. These bacteria possessed more complex walls, since they were covered by an S layer. They stained gram positive during lag and the initial exponential growth phases, but as doubling times increased, the wall fabric underlying the S layer became noticeably thinner and diffuse, and the cells became more fragile to the Gram stain. By stationary phase, these cultures were virtually gram negative.     

Use of urinary gram stain for detection of urinary tract infection in childhood

In this study, urinary culture, urinary Gram stain, and four tests within the urinalysis, leukocyte esterase, nitrite, microscopyfor bacteria, and microscopyforpyuria, were examined in 100 children with symptoms suggesting urinary tract infection. Our purpose was to determine the validity of the urinary Gram stain compared with a combination of pyuria plus Gram stain and overall urinalysis (positiveness of nitrite, leukocyte esterase, microscopy for bacteria, or microscopy for white blood cell). Of 100 children, aged two days to 15 years, 70 (70 percent) had a positive urinary culture: 40 girls (57 percent) and 30 boys (43 percent). Escherichia coli was the most common isolated agent. The sensitivity and specificity of the urinary Gram stain were 80 percent and 83 percent, and that of the combination of pyuria plus Gram stain 42 percent and 90 percent, and that of the overall urinalysis 74 percent and 3.5 percent respectively. Our findings revealed that neither method of urine screen should substitute for a urine culture in the symptomatic patients in childhood.     

Accuracy of tracheal aspirate gram stain in predicting Staphylococcus aureus infection in ventilator-associated pneumonia

Background

The Gram stain can be used to direct initial empiric antimicrobial therapy when complete culture is not available. This rapid test could prevent the initiation of inappropriate therapy and adverse outcomes. However, several studies have attempted to determine the value of the Gram stain in the diagnosis and therapy of bacterial infection in different populations of patients with ventilator-associated pneumonia (VAP) with conflicting results. The objective of this study is to evaluate the accuracy of the Gram stain in predicting the existence of Staphylococcus aureus infections from cultures of patients suspected of having VAP.

Methods

This prospective single-center open cohort study enrolled 399 patients from December 2005 to December 2010. Patients suspected of having VAP by ATS IDSA criteria were included. Respiratory secretion samples were collected by tracheal aspirate (TA) for standard bacterioscopic analysis by Gram stain and culture.

Results

Respiratory secretion samples collected by tracheal aspirates of 392 patients were analyzed by Gram stain and culture. When Gram-positive cocci were arranged in clusters, the sensitivity was 68.4%, specificity 97.8%, positive predictive value 88.1% and negative predictive value 92.8% for predicting the presence of Staphylococcus aureus in culture (p < 0.001).

Conclusions

A tracheal aspirate Gram stain can be used to rule out the presence of Staphylococcus aureus in patients with a clinical diagnosis of VAP with a 92.8% Negative Predictive Value. Therefore, 7.2% of patients with Staphylococcus aureus would not be protected by an empiric treatment that limits antimicrobial coverage to Staphylococcus aureus only when Gram positive cocci in clusters are identified.     

The Mechanism of the Gram Reaction. III. Solubilities of Dye-Iodine Precipitates and Further Studies of Primary Dye Substitutes

Solubilities of dye-iodine precipitates in alcohol and in aqueous safranin solution were determined by direct solubility methods and by photocolorimetric methods. It was found that, increasing precipitate solubility in alcohol or safranin solution gave decreasing differentiation between Gram-positive and Gram-negative bacteria. Dyes which did not stain the cells well as a primary stain did not give good Gram stains, regardless of the solubilities of their precipitates. Some dyes (typified by methylene blue) which gave relatively alcohol-insoluble iodine precipitates gave inferior Gram differentiation because these precipitates were readily soluble in the safranin counterstain.

Solubilities of precipitates of crystal violet and various iodine substitutes were determined photocolorimetrically. The ability of a substance to replace iodine in the Gram stain correlated with its ability to give a precipitate which was only slightly soluble in alcohol and relatively insoluble in aqueous safranin solution.

It was concluded that the usual Gram reagents are not truly specific for the differentiation. Any dye and mordant could be used if the dye was deeply colored, stained the cells well, and if the precipitate of dye and mordant was only slightly soluble in alcohol and relatively insoluble in the counterstain. These factors, combined with those influencing differences in cell membrane permeability, constitute the most important factors in the Gram stain differentiation.

Studies were made concerning the ability of dyes to substitute for crystal violet in the Gram procedure. Of 29 dye samples reported on here for the first time none proved to be good substitutes for crystal violet.     

Use of the Gram stain in microbiology

The Gram stain differentiates bacteria into two fundamental varieties of cells. Bacteria that retain the initial crystal violet stain (purple) are said to be 'Gram-positive,' whereas those that are decolorized and stain red with carbol fuchsin (or safranin) are said to be 'Gram-negative.' This staining response is based on the chemical and structural makeup of the cell walls of both varieties of bacteria. Gram-positives have a thick, relatively impermeable wall that resists decolorization and is composed of peptidoglycan and secondary polymers. Gram-negatives have a thin peptidoglycan layer plus an overlying lipid-protein bilayer known as the outer membrane, which can be disrupted by decolorization. Some bacteria have walls of intermediate structure and, although they are officially classified as Gram-positives because of their linage, they stain in a variable manner. One prokaryote domain, the Archaea, have such variability of wall structure that the Gram stain is not a useful differentiating tool.     

A Fluorescent Gram Stain for Flow Cytometry and Epifluorescence Microscopy

The fluorescent nucleic acid binding dyes hexidium iodide (HI) and SYTO 13 were used in combination as a Gram stain for unfixed organisms in suspension. HI penetrated gram-positive but not gram-negative organisms, whereas SYTO 13 penetrated both. When the dyes were used together, gram-negative organisms were rendered green fluorescent by SYTO 13; conversely, gram-positive organisms were rendered red-orange fluorescent by HI, which simultaneously quenched SYTO 13 green fluorescence. The technique correctly predicted the Gram status of 45 strains of clinically relevant organisms, including several known to be gram variable. In addition, representative strains of gram-positive anaerobic organisms, normally decolorized during the traditional Gram stain procedure, were classified correctly by this method.Gram’s staining method is considered fundamental in bacterial taxonomy. The outcome of the Gram reaction reflects major differences in the chemical composition and ultrastructure of bacterial cell walls. The Gram stain involves staining a heat-fixed smear of cells with a rosaniline dye such as crystal or methyl violet in the presence of iodine, with subsequent exposure to alcohol or acetone. Organisms that are decolorized by the alcohol or acetone are designated gram negative.Alternative Gram staining techniques have recently been proposed. Sizemore et al. (19) reported on the use of fluorescently labeled wheat germ agglutinin. This lectin binds specifically to N-acetylglucosamine in the peptidoglycan layer of gram-positive bacteria, whereas gram-negative organisms contain an outer membrane that prevents lectin binding. Although simpler and faster than the traditional Gram stain, this method requires heat fixation of organisms.Other Gram stain techniques suitable for live bacteria in suspension have been described. Allman et al. (1) demonstrated that rhodamine 123 (a lipophilic cationic dye) rendered gram-positive bacteria fluorescent, but its uptake by gram-negative organisms was poor. This reduced uptake by gram-negative bacteria was attributed to their outer membranes. The outer membrane can be made more permeable to lipophilic cations by exposure to the chelator EDTA (4). Shapiro (18) took advantage of this fact to form the basis of another Gram stain, one which involved comparing the uptake of a carbocyanine dye before and after permeabilizing organisms with EDTA. All of these methods, however, rely on one-color fluorescence, making analysis of mixed bacterial populations difficult.An alternative to the use of stains is the potassium hydroxide (KOH) test. The method categorizes organisms on the basis of differences in KOH solubility. After exposure to KOH, gram-negative bacteria are more easily disrupted than gram-positive organisms. This technique has been used to classify both aerobic and facultatively anaerobic bacteria, including gram-variable organisms (8). In a study by Halebian et al. (9), however, this technique incorrectly classified several anaerobic strains, giving rise to the recommendation that the method should only be used in conjunction with the traditional Gram stain.In this study we demonstrate a Gram staining technique for unfixed organisms in suspension, by using clinically relevant bacterial strains and organisms notorious for their gram variability. The method uses two fluorescent nucleic acid binding dyes, hexidium iodide (HI) and SYTO 13. Sales literature (11) published by the manufacturers of HI (Molecular Probes, Inc., Eugene, Oreg.), which displays a red fluorescence, suggests that the dye selectively stains gram-positive bacteria. SYTO 13 is one of a group of cell-permeating nucleic acid stains and fluoresces green (11). These dyes have been found to stain DNA and RNA in live or dead eukaryotic cells (16). Both dyes are excited at 490 nm, permitting their use in fluorescence instruments equipped with the most commonly available light sources. We reasoned that a combination of these two dyes applied to mixed bacterial populations would result in all bacteria being labeled, with differential labeling of gram-positive bacteria (HI and SYTO 13) and gram-negative bacteria (SYTO 13 only). The different fluorescence emission wavelengths of the two dyes would ensure differentiation of gram-positive from gram-negative bacteria by either epifluorescence microscopy or flow cytometry when equipped with the appropriate excitation and emission filters. While a commercial Gram stain kit produced by Molecular Probes includes HI and an alternative SYTO dye, SYTO 9, we are unaware of any peer-reviewed publications regarding either its use or its effectiveness with traditionally gram-variable organisms.     

Comparison between Gram stain and culture for the characterization of vaginal microflora: Definition of a distinct grade that resembles grade I microflora and revised categorization of grade I microflora

Background  

The microbiological diagnosis of bacterial vaginosis is usually made using Nugent's criteria, a useful but rather laborious scoring system based on counting bacterial cell types on Gram stained slides of vaginal smears. Ison and Hay have simplified the score system to three categories and added a fourth category for microflora with a predominance of the Streptococcus cell type. Because in the Nugent system several cell types are not taken into account for a final score, we carried out a detailed assessment of the composition of the vaginal microflora in relation to standard Gram stain in order the improve the diagnostic value of the Gram stain. To this purpose we compared Gram stain based categorization of vaginal smears with i) species specific PCR for the detection of Gardnerella vaginalis and Atopobium vaginae and with ii) tDNA-PCR for the identification of most cultivable species.