Reading and Reporting Gram Stained Direct Smears (by LabCE)

Continuing Education Credits

P.A.C.E.® Contact Hours (acceptable for AMT, ASCP, and state recertification): 1.5 hour(s) Course number 578-051-20, approved through 6/30/2022

Florida Board of Clinical Laboratory Personnel Credit Hours - General (Microbiology/Mycology/Parasitology): 1.5 hour(s) Course number 20-703333, approved through 9/1/2020

Objectives

• Define a direct smear.
• Describe several ways that Gram stained direct smears are clinically useful.
• Discuss examination of direct smears with respect to: control smears, macroscopic appearance, and characteristics of appropriate microscopic fields.
• Discuss the identification of common nonbacterial elements with respect to: purpose, size, shape, differentiating characteristics, and Gram stain reaction.
• Identify the following types of bacteria found in Gram stained direct smears: gram-positive cocci, gram-negative cocci, gram-positive bacilli, gram-negative bacilli, gram negative diplococci.
• Discuss the procedure for reading Gram stained direct smears with respect to: principle, procedure, and sources of error.

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Course Outline

• Purpose of the Gram Stained Direct Smear
• What is the Value of a Direct Smear?
• Determine the Quality of a Sputum Specimen
• Determine the Quality of a Urine Specimen Submitted for Culture
• Provide the Clinician With Same-Day Information Regarding Possible Pathogens
• Cerebrospinal Fluid and Specimens Collected from Other Sterile Sites
• Correlate Direct Smear Results With Culture Results
• Reading and Reporting Direct Smears
• Gram Stain Principle
• Quality Control Smears
• Macroscopic Evaluation of the Smear
• Thick Smears
• Thin Smears
• Properly Decolorized Smears
• Under-decolorized or Over-decolorized Smears
• Reporting Microscopic Findings
• Contaminated Gram Stain Solution
• Summary of Gram Stain Reading and Reporting Procedure
• Bacteria in Direct Smears
• Gram-positive Cocci
• Gram-positive Diplococci
• Gram-negative Cocci
• Intracellular Bacteria
• Gram-negative Diplococci
• Special Considerations for Genital Smears
• Gram-positive Bacilli
• Gram-negative Bacilli
• Significance of Specific Findings
• Nonbacterial Cells in Direct Smears
• Size and Appearance of Nonbacterial Cellular Elements on Gram Stained Smears
• References
• References

Additional Information

This course describes the morphology and Gram stain reactions of bacteria and nonbacterial elements found in Gram stained smears of clinical material.
Level of Instruction: Basic

Intended Audience: This course is suitable for basic clinical microbiology courses at the post-secondary level. It can also be used as review material for clinical laboratory practitioners, medical students, and pathology residents.

Prerequisites: Skill in the use of the microscope, aseptic techniques, experience preparing and gram staining smears, and experience reading smears from cultures.

Author Credentials: This course was developed by Betty Smith MT (ASCP) and Jaimy Hill MT (ASCP), and was updated by Education Materials for Health Professionals, Inc., under the supervision of Marjorie Spahn MT(ASCP). It was reviewed and adapted for online use by Paul Fekete, M.D. fellow C.A.P.

Copyright: Copyright EMHP Inc., Dayton OH. Licensed to MediaLab Inc., Dacula, GA. Web-based version produced solely by MediaLab Inc.

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