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Endocervical gram stain

Endocervical Gram stain is a method to identify bacteria on tissue from the cervix using a special series of stains.

How is the Test Performed?

This test requires a sample of tissue from the lining of the cervical canal (the opening to the uterus).

You lie on your back with your feet in stirrups. The health care provider will insert an instrument called a speculum into the vagina. This instrument is used during regular female pelvic exams. It opens the vagina to better view certain pelvic structures.

After the cervix is cleaned, a dry, sterile swab is inserted through the speculum to the cervical canal and gently turned. It may be left in place for a few seconds to absorb as many germs as possible.

The swab is removed and sent to a laboratory, where it will be smeared on a slide. A series of stains called a Gram stain is applied to the sample. A laboratory technician looks at the stained smear under the microscope for the presence of bacteria. The color, size, and shape of the cells help identify the type of bacteria.

Preparation for the Test

Do not douche for 24 hours before the procedure.

How the Test will Feel

You may feel minor discomfort during specimen collection. This procedure feels very much like a routine Pap smear.

Why is the Test Performed?

This test is used to detect and identify abnormal bacteria in the cervix area. If you develop signs of an infection or think that you have a sexually transmitted disease (such as gonorrhea), this test can help confirm the diagnosis. It can also identify the germ that is causing the infection.

This test is rarely done because it has been replaced with more accurate ones.

Normal Results for Endocervical gram stain

A normal result means no abnormal bacteria are seen in the sample.

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

  • Bacterial vaginosis
  • Chlamydia
  • Gonorrhea
  • Yeast infection

The test may also be performed for gonococcal arthritis, to determine the site of the initial infection.

Endocervical gram stain Risks

There is virtually no risk.


If you have gonorrhea or another sexually transmitted disease, it is very important that all of your sexual partners also receive treatment, even if they have no symptoms.


Cohen MS. Approach to the patient with a sexually transmitted disease. In: Goldman L, Ausiello D, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 293.

Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, endometritis, and salpingitis. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 23. 

Workowski KA, Berman S; Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010 Dec 17;59(RR-12):1-110.

Review Date: 12/2/2014
Reviewed By: Irina Burd, MD, PhD, Assistant Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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