Knowledge, Attitude and Practice with Regard to Gram stain, as a Preliminary Test for Clinical Diagnosis among the Internees and Postgraduates, in a Tertiary Care Teaching Hospit


Raja Vikram Prasad1 , Mohammad Abdul Mushtaq Pasha2 , Afsar Fatima3 , Deepa Latha Ciddhavaduta4 , Veeresappa Doddi Kummari5

BACKGROUND Hans Christian Gram, a Danish pathologist originally devised the Gram staining method in 1882 for identification of Gram positive and Gram-negative bacteria and is the gold standard method for preliminary detection before inoculating for culture and sensitivity for better treatment outcome. In the present era, use of irrational antimicrobials has led to antimicrobial resistance which can be resolved by routine usage of Gram stain. METHODS This is a cross sectional study of 2 months duration (May 2020 - June 2020) with 172 subjects. Institutional ethical clearance and pharmaco-vigilance program of India permission was obtained. All interns and post-graduates who were available at the time of interview, and who gave written informed consent were included in the study. Those who did not give written informed consent and those who were absent or unavailable were excluded. Pre tested questionnaire was validated using Cronbach’s alpha for internal consistency and was filled voluntarily. Data was collected, compiled and analysed for results. RESULTS Among 172 subjects who participated in the study, 99 (57 %) are females and 73 (43 %) are males. 88 (51 %) are post-graduates and 84 (49 %) are interns. 100 % had knowledge about Gram stain, 47 (27 %) participants knew about procedure timing as 5 minutes for Gram staining and 26 (15 %) participants thought that test can be done at bedside. 90 (52 %) knew that test can be done for all specimens. 169 (98 %) had knowledge on the Gram stain which could help for provisional diagnosis. 119 (69 %) agreed that test was very cost effective. 28 (16 %) agreed that Gram stain was a better test for provisional diagnosis. 63 (36.6 %) were practicing regularly and 10 (6 %) were practicing Gram stain for appropriate antimicrobial use. CONCLUSIONS The present study concluded 100 % of the study participants had knowledge with regard to Gram staining, 27 % knew that the time taken was 5 minutes to perform test. 15 % knew that it can be done at bedside. 63 (36.6 %) were practicing regularly and 10 (6 %) were practicing as initial step for all clinical confirmations for appropriate antimicrobial treatment for better outcome.