Endocervical Gram stain

Definition:

This is a method of staining microorganisms (bacteria) using a special series of stains. In this test, a specimen from the cervix is stained and then examined under the microscope.

The Gram stain method can be applied to almost any clinical specimen and is one of the most commonly used techniques for the rapid diagnosis of bacterial infections.

Alternative Names:
Gram stain of cervix

How the test is performed:

A sample is obtained from the lining of the cervical canal (the tissue which lines the opening leading into the uterus). You will be asked to lie on your back with your feet placed in stirrups (devices used to support your feet and help position you in the best way to do the testing).

Like a regular pelvic examination, a speculum (an instrument used to stretch open the vagina or birth canal in order to better examine some of the pelvic organs) will be inserted and opened slightly.

The cervix is cleaned so there is no mucus. A dry, sterile swab is then inserted and rotated within the cervical canal. It may be left in place for several seconds to absorb as many of the organisms as possible.

The swab is then removed and sent to a laboratory where it will be smeared on a slide. The specimen is stained with a series of stains, together called a Gram stain. It is first stained with crystal violet stain, then iodine, then decolorized, then stained with safranin.

The stained smear is then examined under the microscope for the presence of bacteria. The color, size, and morphologic appearance (shape) of the cells help make it possible to identify the infecting organism.

How to prepare for the test:
Do not douche for 24-hours before the procedure.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:
How the test will feel:
There may be minor discomfort during specimen collection. This procedure feels very much like a routine Pap smear.
Why the test is performed:
The test is used to detect and identify abnormal bacteria in the area involving the cervix. If signs of an infection develop or a sexually transmitted disease (such as gonorrhea) is suspected, this test can help with confirmation and identification of an abnormal organism.
Normal Values:
There are no abnormal bacteria present. Note that the normal cervix has "friendly" bacteria that should be seen by Gram stain.
What abnormal results mean:
  • Gonorrhea
  • Chlamydial
  • Bacterial vaginosis
  • Yeast infection
Additional conditions under which the test may be performed:
What the risks are:
There is virtually no risk.
Special considerations:
If gonorrhea or another sexually transmitted infection is present, it is very important that your sexual partner(s) receive treatment also, even if there are no symptoms.

Review Date: 1/7/2002
Reviewed By: Camille Kotton, M.D., Infectious Diseases Division, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.
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