Do I need antibiotics if it says mixed flora in the urine …

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    No, you don’t.

    Urine is a difficult specimen to deal with. It almost always gets contaminated by bacteria on the skin or at the tip of the urethra.

    There are 2 rules to say that whatever grows is not a contaminant;

    1. It must not be a mixture of different organisms. There should be only one (or at most two) type of organism grows.
    2. That organism must be present at a significant amount. Normally the significant amount is 10^5 (or 100,000) CFU/ml. THe number may be lower than this if there are any additional conditions.

    Also, it is only a lab result. What matter is that you (the patient) have any symptoms indication of infection. If yes, you should see the doctor and recollect the urine to find the true culprit.

    Let your doctor decide what to do, as it is the whole picture which decides the correct actions.

    But the general answer to this question is a mixed flora in the urine culture means the urine sample is polluted by bacteria from other parts of your body. Especially women are prone to have their urine samples contaminated by bacteria from the vaginal discharge. It is needed to have instructions of how to take the urine sample not being contaminated by the vaginal discharge. This procedure is called “A washing, mid stream urine sample “.

    If having a Lower Urinary Tract Infection “, this most often is caused by only one bacteria strain at the time.

    There of course are exceptions of this.

    In short: If you are not having symptoms of a UTI, the only finding is a mixed urine culture, usually it is not necessary to use antibiotics.

    If you have symptoms like fever, often having to urinate or a burning pain when and after urimating, you should have a new urine sample taken and be instructed how to take it.

    Again:! Follow the advices from your doctor!

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    Mixed flora is basically a nice way of saying there are skin bacteria in this sample and it wasn’t obtained in the most clean way possible.

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    You may have to repeat the urine specimen if your doctor felt that you had a urinary tract infection. However, if the pretest probability of disease was low or the specimen was sent by mistake, there’s nothing to do. I mean, no antibiotic is needed.

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    Flora refers to the organisms that we see when we examine it in the lab. Mixed means we see both what we expect to see (the normal ones) and what are not supposed to be there (the ones we should see for example, in the skin or the vagina or anus). Generally speaking, mixed flora means contamination of the urine specimen, hence it does not help in any way to make good decision how to treat. Why is this so? There is supposed to be just one foreign organism — usually the pathologic one, that remains in urine if it is truly infected. Because being pathologic and “strong” at that, it discourages or renders difficult the growth of other ones, especially those normal ones. It’s like an invasion. It kills all the guards and other armies. Hence, if we see mixed organisms, where is the pathology? They seem to be friendlies living in harmony….

    However, there appears to be some evidence that mixed flora may represent an actual mixed infection, especially in certain chronic conditions like the presence of foreign body like a catheter. Thus it is more prudent to treat them as such.

    I am guessing you are female…Ladies will invariably have “resident” or mixed flora in their collection of a specimen UNLESS they are explained how to collect “clean catch” and midstream.

    You DO NOT need to worry here…except in your collection of a urine specimen for Culture. You would not get a useable culture result on the specimens you infer to above. What is meant by “resident” and “mixed” flora is (again assuming you are a lady) that all the organisms present are those that would be expected and none are presenting as being in a majority to the rest of the “normal” flora….such that shows up as mixed flora in a urine culture.

    Urine is sterile unless you have a bladder or kidney infection. No urine culture w/ any of the aforementioned wording is a properly collected specimen and follows the GIGO rule…garbage in garbage out. Vaginal flora is the type of flora that will recieve these wordings on a report and it simply means it is a contaminated/improperly collected specimen and for all intents is a complete wash and has really given the MD nothing to work with. He cannot be sure there is no infection of the urinary tract if the causative agent has been overgrown by contamination.

    There should be reports of “no growth” or “growth of a # of “ certain type of bacteria.

    It is political i am afraid that urine culture reports with “mixed” or “resident” flora don,t automatically get a more correct report requesting a new specimen collected “midstream” and “clean catch”. 48 hours after collection of first specimen is the fastest a final report comes back. Some labs will request a new specimen if at 24 hours the culture is obviously contaminated.

    I hope this helps….i added the last part when i still could imagine some unanswered questions to what i originally posted.

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    From a urine culture and sensitivity blood test, the lab results came back that ANOTHER different type of antibiotics is better suited to knock out this specific bacteria strain, That is it !

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    At first,

    Intestinal flora is not a single class of bacteria, they are different types and classes of bacteria. Classically two class

    1. Gram positive
    2. Gram negative

    According to classification of bacteria, classically two types of antibiotics

    1. Broad spectrum antibiotics :- this kind of antibiotics either killed or stop growth of both kind of bacteria.
    2. Narrow spectrum :- this kind of antibiotics either kill or stop growth of either Gram positive or Gram negative bacteria.

    As your questions

    Do antibiotics permanently affect the intestinal flora?

    It depends on the which antibiotics you take.

    If you take Broad spectrum antibiotics you temporarily loss in small amounts of Intestinal flora.

    If you take Narrow spectrum antibiotics it also depends on which narrow spectrum antibiotics.

    If you take those kind of antibiotics which kill Gram positive only, then you loss your Gram positive Intestinal flora in temporary or small amount.

    If you take those kind of antibiotics which kill Gram negative only, then you loss your Gram negative Intestinal flora in temporary or small amount.

    But you can’t loss your Intestinal flora in the permanent form.

    What does it mean?

    1). The method used to collect the urine sample was not sterile.

    Urine cultures are mostly done to diagnose urinary tract infections(UTI). Such infections mostly, if not always, are caused by a single organism in each case (organisms vary, but the agent is single in each case). The purpose of the Culture is to isolate that organism, then test drugs recommended against it to see if they”ll work.

    Some of the organisms that cause UTI are also found on the skin and in the gut, and can contaminate the terminal end of the urethra, just before the opening. If these organisms grow together with a pathogen(the organism causing the UTI) on culture, as when sterile collection technique( as instructed ) is not followed,

    2). The lab cannot interpret the culture, as in, which organism between the two/ among the three/more is responsible for the UTI. The organisms can be identified, but usually this is not useful and not routinely done. An exception may be when there are two, and one is Salmonella spp.

    3). The lab cannot test recommended drugs for treating a disease cause by a pathogen they can’t pinpoint.

    4). The urine sample must be recollected.

    5). Effective treatment may be delayed.

    All urine will have some bacteria because it flows through the urethra. When they say “Normal Flora”, the are saying you picked up a level from the outer 1.5 inches of the urethra but no bacteria predominate in the mix of bugs and there aren’t greater than expected amounts found; Hence, “Normal Flora” or “Expected Numbers” are seen.

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    TLTR: Mixed flora alone = no prob.

    All of our skin has bacteria…it sounds gross, but honestly, bacteria cover everything in our lives. There are some organisms that are more commonly found living on the skin: Staphylococcus epidermidis, Corynebacterium, etc. When found together on a culture of a swab taken from the skin, it is most often reported as “mixed skin flora.” These are not likely to cause disease; however, our skin does take on bacteria we are exposed to.

    Commonly people living in the same house will have similar mixes of bacteria on their skin. This doesn’t usually cause a problem but when there is a compromise in the skin’s naturally protective barrier (like a cut, bug bite that’s been scraped, ingrown hair), bacteria on the skin’s surface can delve a little deeper and cause infection of the skin (cellulitis) or a collection of infection (abscess or boil). This is most often caused by bacteria like Staphylococcus aureus, and some versions are more resistant to antibiotic (MRSA or methicillin-resistant staph aureus).

    The best option is to treat any cut or break in the skin with good anti-microbial soap (like dial) and water. Apply and antibacterial ointment and cover if the area may become dirty.

    In short, it’s the natural flora (bacteria) that lives within the prepucial cavity of intact men and within the vagina and among the labial folds of intact women and girls. This flora is probiotic, meaning that it’s beneficial, much like the bacteria living within our gastrointestinal tract. They are however different species of bacteria. One example of this difference is that the most common cause of urinary tract infections is the unintentional transfer of gut bacteria, usually Eserichia Coli (E. Coli), from the GI tract, by way of the anus, to the urinary tract. This is usually more common in females simply because of closer proximity and a shorter urethra, however males are not immune to UTIs. Circumcised males lack this flora simply because there is nowhere for it to grow and as such lack the protection that it provides. An example of the protection provided by urogenital flora is when intact males and females get yeast infections following treatment with antibiotics. The antibiotics kill the flora, or at least weaken it, to where yeast (a fungus) can establish growth and, much like any other invasive species, grows unchecked leading to an infection.

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