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2016 ; 9
(ä): 216
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An optimized staining technique for the detection of Gram positive and Gram
negative bacteria within tissue
#MMPMID27071769
Becerra SC
; Roy DC
; Sanchez CJ
; Christy RJ
; Burmeister DM
BMC Res Notes
2016[Apr]; 9
(ä): 216
PMID27071769
show ga
BACKGROUND: Bacterial infections are a common clinical problem in both acute and
chronic wounds. With growing concerns over antibiotic resistance, treatment of
bacterial infections should only occur after positive diagnosis. Currently,
diagnosis is delayed due to lengthy culturing methods which may also fail to
identify the presence of bacteria. While newer costly bacterial identification
methods are being explored, a simple and inexpensive diagnostic tool would aid in
immediate and accurate treatments for bacterial infections. Histologically,
hematoxylin and eosin (H&E) and Gram stains have been employed, but are far from
optimal when analyzing tissue samples due to non-specific staining. The goal of
the current study was to develop a modification of the Gram stain that enhances
the contrast between bacteria and host tissue. FINDINGS: A modified Gram stain
was developed and tested as an alternative to Gram stain that improves the
contrast between Gram positive bacteria, Gram negative bacteria and host tissue.
Initially, clinically relevant strains of Pseudomonas aeruginosa and
Staphylococcus aureus were visualized in vitro and in biopsies of infected,
porcine burns using routine Gram stain, and immunohistochemistry techniques
involving bacterial strain-specific fluorescent antibodies as validation tools.
H&E and Gram stain of serial biopsy sections were then compared to a modification
of the Gram stain incorporating a counterstain that highlights collagen found in
tissue. The modified Gram stain clearly identified both Gram positive and Gram
negative bacteria, and when compared to H&E or Gram stain alone provided
excellent contrast between bacteria and non-viable burn eschar. Moreover, when
applied to surgical biopsies from patients that underwent burn debridement this
technique was able to clearly detect bacterial morphology within host tissue.
CONCLUSIONS: We describe a modification of the Gram stain that provides improved
contrast of Gram positive and Gram negative microorganisms within host tissue.
The samples used in this study demonstrate that this staining technique has
laboratory and clinical applicability. This modification only adds minutes to
traditional Gram stain with reusable reagents, and results in a cost- and
time-efficient technique for identifying bacteria in any clinical biopsy
containing connective tissue.