What does mixed flora in urine mean?

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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.

    Contamination, because deep in the urinsry tract here cannot (within reasonable odds) be such a diverse flora with several different species of bacteria. By contrast, such a ecosystem is the norm on skin. Thus the bacteria that grows in the sample are not the one(s) living in the bladder, if any. The sample is useless in diagnosing or excluding an urinary tract infection.

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    From what I know about it is the same bacteria that we find on our skin. If there are Flora there, then it could be from your hands.

    If you are getting problems, then you need to see a doctor and they will send it to the lab and make sure there is no contamination or infection.

    You could always type this question in your search engine and see what you can find from either webmd or a urinary site.

    That will help you, but what I cannot understand is why, if you had a test that would have been done at the doctor’s office and why they did not explain what it was and if it was normal or infection????

    Very puzzling to me.

    That there were no bacteria seen on the culture, just mixed urogenital flora – the normal stuff that lives in the GU tract. So, essentially, the urine culture was negative.

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    • Depends on why you got the urine test done.
    • Did you have urinary symptoms – burning during urination, increase frequency of urination
    • Do you have a history of urinary stones?
    • Do you have diabetes?
    • Do you have a history of urinary catheterization in the recent past?
    • Urine is normally sterile – means it doesn’t grow organisms
    • Mixed flora could mean external contamination – which could be from your skin in the private parts, contaminated bottle, contamination by microbiology staff.
    • All the above information has to be combined to make a proper interpretation.

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    most likely it means too many organisms are found in your urine sample. which is very common if you havenot collected the sample in a sterile manner i.e correct manner. Inappropriate method of collection causes contamination of the sample with the many bacteria found on our skin known as commensals.

    usually in urine infection we have a single or two culprits causing infection.

    so if it is simply mixed flora then i think doctor will request a redo test.

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    Mixed flora usually means the urethral bacteria clouding a true negative answer.

    They could be important if you are immunocompromised and “let” all those bacteria grow because you’ve tamped down the effectiveness of your immune system. If that’s the case, they might have significance if reported in great numbers.

    The fact that they didn’t specify what the bacteria are is a good reason to believe they are insignificant contaminants.

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    No the girl does not have a UTI.

    She has a urine sample that is contaminated with vulvovaginal bacteria.

    Even if she had a single organism, it would be dicey to call it a UTI under 100K colony forming units. But mixed means it is just junk from the skin folds.

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    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!

    I was asked to update the answers to this question. The other answers are pretty complete.

    Bit I would not agree we should sound critical of women who cannot give a “clean catch” specimen. If it were easy, all women would do it right. Not being a woman I struggled to explain how a women should do this method of urine collection. I know many women don’t check themselves with a mirror and might no know the location of the opening of the urethra.

    This paragraph is graphic. Do we as medical practionners know whether women always give a clean stream when the labia are spread out of the way? If the urine dribbles from the urethra to the vaginal mucosa to the cup, all bets are off. And what if it requires two hands to spread the labia? Who holds the specimen cup. Maybe voiding into a plastic “hat” solves this problem, but if that hat is not sterile, that may be the source of the contamination we call mixed flora.

    Other issue: how many hours passed between the voiding of the specimen and preparing the culture? Bacteria multiply quickly in urine.

    For this reason a four hour nitrite test on the urine may help us to better interpret the results. If we have a urine that has been in the bladder 4 hours and promptly shows nitrite (from the action of bacteria on the urea), I think most clinician would disregard the “mixed flora” report and treat the patient with an antibiotic. BTW nitrite is on the usual dipsticks and you can also buy a nitrite and white blood cell dipticks about 3 for $10 to $12 at pharmacies (Brand name AZO test strips). A positive nitrite on a freshly tested urine that has been in the bladder for 4 hours is highly suggestive of infection or the urinary system, though not all bacteria will split urea to form nitrite.

    Please let me know if this post gave you some new information or on the other hand is not well explained.

    Between the vaginal opening the the clitoris.

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