Gram staining 12935 221491425 2008-06-24T19:04:57Z DOI bot 6652755 Citation maintenance. Formatted: volume, pages. You can [[WP:DOI|use this bot]] yourself! Please [[User:DOI_bot/bugs|report any bugs]]. [[Image:Gram Stain Anthrax.jpg|thumb|right|300px|Gram-positive [[anthrax disease|anthrax]] bacteria (purple rods) in [[cerebrospinal fluid]] sample. If present, a Gram-negative bacterial species would appear pink. (The other cells are [[white blood cell]]s).]] '''Gram staining''' (or '''Gram's method''') is an [[empiricism|empirical]] method of differentiating [[bacterium|bacterial]] species into two large groups ([[Gram-positive]] and [[Gram-negative]]) based on the chemical and physical properties of their [[cell wall]]s.<ref name=Bergey_1994>{{cite book | last = Bergey | first = David H. | coauthors = John G. Holt; Noel R. Krieg; Peter H.A. Sneath | title = Bergey's Manual of Determinative Bacteriology | edition = 9th ed. | publisher = Lippincott Williams & Wilkins | year = 1994 | id = ISBN 0-683-00603-7 }}</ref> The method is named after its inventor, the [[Denmark|Danish]] scientist [[Hans Christian Gram]] (1853 &ndash; 1938), who developed the technique in [[1884]] to discriminate between [[pneumococcus|pneumococci]] and ''[[Klebsiella pneumoniae]]'' bacteria.<ref name=Gram_1884>{{cite journal | authorlink = Hans Christian Gram | last = Gram | first = HC | title = Über die isolierte Färbung der Schizomyceten in Schnitt- und Trockenpräparaten | journal = Fortschritte der Medizin | year = 1884 | volume = 2 | pages = 185–89 }}</ref> ==Uses== It is used to differentiate [[bacterium|bacterial]] species into two large groups ([[Gram-positive]] and [[Gram-negative]]) based on the chemical and physical properties of their [[cell wall]]s. Gram staining is not used to classify [[archaea]], since these microorganisms give very variable responses that do not follow their [[Phylogenetics|phylogenetic groups]]<ref>{{cite journal |author=Beveridge TJ |title=Use of the gram stain in microbiology |journal=Biotech Histochem |volume=76 |issue=3 |pages=111–8 |year=2001 |pmid=11475313 |doi=10.1080/714028139}}</ref>. ===Research=== Gram staining is a common procedure in the traditional [[Bacteriology|bacteriological]] [[laboratory]].<ref name=Sherris>{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | pages = 232 &ndash; 3 |edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0838585299 }}</ref> The technique is used as a tool for the differentiation of Gram-positive and Gram-negative bacteria, as a first step to determine the identity of a particular bacterial sample.<ref name=Madigan_2004>{{cite book | last = Madigan | first = MT | coauthors = Martinko J; Parker J | title = Brock Biology of Microorganisms | edition = 10th Edition | publisher = Lippincott Williams & Wilkins | year = 2004 | id = ISBN 0-13-066271-2 }}</ref> The Gram stain is not an infallible tool for diagnosis, identification, or phylogeny, however. It is of extremely limited use in environmental microbiology, and has been largely superseded by molecular techniques even in the medical microbiology lab. Given that some organisms are Gram-variable (i.e. they may stain either negative or positive), and that some organisms are not susceptible to either stain used by the Gram technique, its true utility to researchers should be considered limited and non-specific. In a modern environmental or molecular microbiology lab, most identification is done using genetic sequences and other molecular techniques, which are far more specific and information-rich than differential staining. ===Medical=== Gram stains are performed on [[body fluid]] or [[biopsy]] when [[infection]] is suspected. It yields results much more quickly than [[Microbiological culture|culture]], and is especially important when infection would make an important difference in the patient's treatment and prognosis; examples are [[cerebrospinal fluid]] for [[meningitis]] and [[synovial fluid]] for [[septic arthritis]].<ref name=Sherris /><ref name=Søgaard_2007>{{cite journal |author=Søgaard M, Nørgaard M, Schønheyder H |title=First notification of positive blood cultures: high accuracy of the Gram stain report ''(Epub ahead of publication)'' |journal=J Clin Microbiol |volume= 45|issue= |pages= 1113|year= 2007 |pmid=17301283 |doi=10.1128/JCM.02523-06}}</ref> As a general rule (which has exceptions), Gram-negative bacteria are more [[pathogen]]ic due to their outer membrane structure. The presence of a [[Capsule (microbiology)|capsule]] will often increase the virulence of a [[pathogen]]. Additionally, Gram-negative bacteria have [[lipopolysaccharide]] in their outer membrane, an [[endotoxin]] which increases the severity of [[inflammation]]. This inflammation may be so severe that [[septic shock]] may occur. Gram-positive infections are generally less severe because the human body does not contain [[peptidoglycan]]; in fact, humans produce an [[enzyme]] ([[lysozyme]]) that attacks the open peptidoglycan layer of Gram-positive bacteria. Gram-positive bacteria are also frequently much more susceptible to [[beta-lactam antibiotic]]s, such as [[penicillin]]. Exceptions to the rule include branching and filamentous Gram-positive bacteria such as ''[[Mycobacterium tuberculosis]]'' and other agents of [[tuberculosis]], or ''[[Nocardia]]'' species, the agents of [[nocardiosis]] and some types of [[actinomycetoma]]. These organisms present unique problems in diagnosis and treatment, and special stains such as the [[Ziehl-Neelsen stain]] and the [[Kinyoun stain]] are used in their laboratory workup. ==Staining mechanism== Gram-positive bacteria have a thick mesh-like cell wall made of [[peptidoglycan]] (50-90% of cell wall), which stain purple and Gram-negative bacteria have a thinner layer (10% of cell wall), which stain pink. Gram-negative bacteria also have an additional outer membrane which contains [[lipid]]s, and is separated from the cell wall by the periplasmic space. There are four basic steps of the Gram stain, which include applying a primary stain ([[crystal violet]]) to a heat-fixed smear of a bacterial culture, followed by the addition of a ''[[mordant]]'' (Gram's [[iodine]]), rapid decolorization with [[Ethanol|alcohol]] or [[acetone]], and ''counterstaining'' with [[safranin]] or [[basic fuchsin]]. [[Methyl violet|Crystal violet]] (CV) dissociates in aqueous solutions into CV<sup>+</sup> and chloride (Cl<sup> – </sup>) ions. These ions penetrate through the cell wall and cell membrane of both Gram-positive and Gram-negative cells. The CV<sup>+</sup> ion interacts with negatively charged components of bacterial cells and stains the cells purple. Iodine (I<sup> – </sup> or I<sub>3</sub><sup> – </sup>) interacts with CV<sup>+</sup> and forms large complexes of crystal violet and iodine (CV – I) within the inner and outer layers of the cell. When a decolorizer such as alcohol or acetone is added, it interacts with the lipids of the cell membrane. A Gram-negative cell will lose its outer membrane and the peptidoglycan layer is left exposed. The CV – I complexes are washed from the Gram-negative cell along with the outer membrane. In contrast, a Gram-positive cell becomes dehydrated from an ethanol treatment. The large CV – I complexes become trapped within the Gram-positive cell due to the multilayered nature of its peptidoglycan. The decolorization step is critical and must be timed correctly; the crystal violet stain will be removed from both Gram-positive and negative cells if the decolorizing agent is left on too long (a matter of seconds). After decolorization, the Gram-positive cell remains purple and the Gram-negative cell loses its purple color. Counterstain, which is usually positively-charged safranin or basic fuchsin, is applied last to give decolorized Gram-negative bacteria a pink or red color.<ref name="Beveridge_and_Davies_1983"> {{cite journal | last = Beveridge | first = T.J. | authorlink = | coauthors = Davies, J.A. | title = Cellular responses of ''Bacillus subtilis'' and ''Escherichia coli'' to the Gram stain | journal = J. Bacteriol. | volume = 156 | issue = 2 | pages = 846–858 | date = | publisher = | url = http://jb.asm.org/cgi/reprint/156/2/846.pdf | format = [[PDF]] | pmid = 6195148 | accessdate = 2007-02-17 }} </ref><ref name="Davies_et_al_1983"> {{cite journal | last = Davies | first = J.A. | authorlink = | coauthors = G.K. Anderson, T.J. Beveridge, H.C. Clark | title = Chemical mechanism of the Gram stain and synthesis of a new electron-opaque marker for electron microscopy which replaces the iodine mordant of the stain | journal = J. Bacteriol. | volume = 156 | issue = 2 | pages = 837–845 | date = | publisher = | url = http://jb.asm.org/cgi/reprint/156/2/837.pdf | format = [[PDF]] | pmid = 6195147 | accessdate = 2007-02-17 }} </ref> Some bacteria, after staining with the Gram stain, yield a ''Gram-variable'' pattern: a mix of pink and purple cells are seen. The genera ''[[Actinomyces]]'', ''Arthobacter'', ''[[Corynebacterium]]'', ''[[Mycobacterium]]'', and ''[[Propionibacterium]]'' have cell walls particularly sensitive to breakage during cell division, resulting in Gram-negative staining of these Gram-positive cells. In cultures of ''[[Bacillus]]'', ''Butyrivibrio'', and ''[[Clostridium]]'' a decrease in peptidoglycan thickness during growth coincides with an increase in the number of cells that stain Gram-negative<ref name="Beveridge_1990"> {{cite journal | last = Beveridge | first = T.J. | authorlink = | coauthors = | title = Mechanism of gram variability in select bacteria | journal = J. Bacteriol. | volume = 172 | issue = 3 | pages = 1609–1620 | date = | publisher = | url = http://jb.highwire.org/cgi/reprint/172/3/1609.pdf | format = [[PDF]] | pmid = 1689718 | accessdate = 2007-02-17 }} </ref> In addition, in all bacteria stained using the Gram stain, the age of the culture may influence the results of the stain. ==Gram staining protocol== {{Wikibookspar|Transwiki|Gram staining}} # Make a slide of tissue or body fluid that is to be stained. Heat the slide for few seconds until it becomes hot to the touch so that bacteria are firmly mounted to the slide. # Add the primary stain [[Methyl violet|crystal violet]] and wait 1 minute. Rinse gently with water. This step colors all cells violet. # Add Gram's iodine, for 30 seconds. It is not a stain; it is a [[mordant]]. It doesn't give color directly to the bacteria but it fixes the crystal violet to the bacterial cell wall. All cells remain violet. # Wash with ethanol and acetone, the decolorizer. If the bacteria is Gram-positive it will retain the primary stain. If it is Gram-negative it will lose the primary stain and appear colorless. # Add the secondary stain, [[safranin]], and wait 1 min, then wash with water for a maximum of 5 seconds. If the bacteria is Gram-positive then the cell will retain the primary stain, will not take the secondary stain, and will appear black-violet. If the bacteria is Gram-negative then the cell will lose the primary stain, take secondary stain, and will appear red-pink. ''Crystal violet'' is 2 g of 90% crystal violet dissolved in 20 ml of 95% [[ethyl alcohol]]. ''Gram's iodine'' is 1 g of [[iodine]], 2 g of [[potassium iodide]], dissolved in 300 ml of [[distilled water]]. ''Decolorizer'' is 50% ethyl alcohol, 50% acetone.[http://www.uphs.upenn.edu/bugdrug/antibiotic_manual/Gram1.htm ] Variations of the method are quite common, such as [[gentian violet]] instead of crystal violet and [[basic fuchsin]] instead of safranin. ==Examples== ===Gram-negative bacteria=== {{Main|Gram-negative bacteria}} The [[proteobacteria]] are a major group of Gram-negative bacteria. Other notable groups of Gram-negative bacteria include the [[cyanobacteria]], [[spirochaete]]s, [[green sulfur bacteria|green sulfur]] and [[green non-sulfur bacteria|green non-sulfur]] bacteria. These also include many medically relevant Gram-negative [[Coccus|cocci]], [[bacilli]] and many bacteria associated with [[nosocomial infection]]s. ===Gram-positive bacteria=== {{Main|Gram-positive bacteria}} In the original bacterial phyla, the Gram-positive forms made up the [[phylum (biology)|phylum]] [[Firmicutes]], a name now used for the largest group. It includes many well-known genera such as ''[[Bacillus]]'', ''[[Listeria]]'', ''[[Staphylococcus]]'', ''[[Streptococcus]]'', ''[[Enterococcus]]'', and ''[[Clostridium]]''. It has also been expanded to include the Mollicutes, bacteria like ''[[Mycoplasma]]'' that lack cell walls and so cannot be stained by Gram, but are derived from such forms. ==See also== * [[Bacterial cell structure]] * [[Staining (biology)]] ==References== <!-- --------------------------------------------------------------- See http://en.wikipedia.org/wiki/Wikipedia:Footnotes for a discussion of different citation methods and how to generate footnotes using the <ref> & </ref> tags and the {{Reflist}} template -------------------------------------------------------------------- --> {{Reflist|2}} ==External links== * [[commons: Category:Gram stains|More examples of Gram staining]] * [http://www.tgw1916.net/movies.html Gram staining technique video] [[Category:Bacteriology]] [[Category:Staining]] [[Category:Microbiology]] [[ar:صبغة غرام]] [[zh-min-nan:Gram ní-sek-hoat]] [[ca:Tinció de Gram]] [[cs:Gramovo barvení]] [[da:Gramfarvning]] [[de:Gram-Färbung]] [[es:Tinción de Gram]] [[eo:Gram-kolorigo]] [[eu:Gram tindaketa]] [[fa:رنگ‌آمیزی گرم]] [[fr:Coloration de Gram]] [[ko:그람 염색]] [[id:Pewarnaan Gram]] [[it:Colorazione di Gram]] [[he:צביעת גרם]] [[lt:Gramo dažymas]] [[hu:Gram-festés]] [[nl:Gram-kleuring]] [[ja:グラム染色]] [[no:Gramfarging]] [[nn:Gramfarging]] [[pl:Barwienie metodą Grama]] [[pt:Técnica de Gram]] [[ro:Coloraţie Gram]] [[ru:Метод Грама]] [[sk:Farbenie podľa Grama]] [[sl:Barvanje po Gramu]] [[fi:Gramvärjäys]] [[sv:Gramfärgning]] [[vi:Nhuộm Gram]] [[tr:Gram boyama]] [[uk:Фарбування за Грамом]] [[zh:革蘭氏染色]]