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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.
No. Mixed urogenital flora simply means no bacteria, just the natural-occurring cells that are expected to be found in urine. It’s not a UTI but a contaminant from the genitalia. However, if you have had urinary tract infections in the past, you may be left with cystitis, or inflammation of the bladder lining from said infections but not an active infection. You may require a short-term overactive bladder-type medication from your care provider to help the lining heal and to curb the symptoms from it. Please increase your fluid intake and avoid bladder irritants like caffeine, alcohol, spicy foods, carbonation, and pepper in your diet to help until you can be seen by a care provider for evaluation.
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You don’t. Your body is loaded with flora; most of it is there to maintain a healthy body. If your doctor ordered a urinalysis and culture because you have symptoms of a UTI, the test is negative unless your culture shows >100K organisms like E.Coli or another similar pathogen. If you’re having symptoms like dysuria, push fluids. Talk to your doctor about a course of pyridi…
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;
- It must not be a mixture of different organisms. There should be only one (or at most two) type of organism grows.
- 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.
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.
Disclaimer:
This answer is not a substitute for professional medical advice. This answer is for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Quora users who provide responses to health-related questions are intended third party beneficiaries with certain rights under Quora’s Terms of Service (http://www.quora.com/about/tos).
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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.
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It is complicated. When a male provides a urine specimen for a culture, the best technique for acquisition is to cleanse the head of the penis and obtain the urine well after the urine starts and before it stops flowing (clean catch/mid-stream). People don’t realize that the interpretation of the urine culture is not binary. If the male has greater than 10,000colonies of bacteria/cc of urine growing after providing the clean catch mid stream urine that male would have an 80% probability of having a true urine infection. So the result has to be interpreted in statistical terms. Now a female has “indoor plumbing” so it is not as easy to provide a suitable urine specimen. As the urine leaves the urethra, it still has to transit the introitus where vaginal bacteria can become part of the specimen and subsequently grow on the agar plate. For women then, a voided urine specimen should demonstrated greater than 100,000 colonies of bacteria/ cc of urine to have a 90–95% chance of representing a “true” urine infection. For the matter at hand we are asked to interpret the significance of “mixed flora” on the urine culture. The medical student will observe that most urine infections occur when one bacteria takes off growing and, as such, it is the only bacteria to be found growing on the plate. When multiple bacteria are growing on the plate, the medical student will dismiss the culture as contaminated with skin bacteria during collection which happens often in females vs males as described above. In this instance we have symptoms as well as a culture that most often would be considered negative as it showed numerous bacteria to be present. Those symptoms are important. As a Pediatric Urologist I often see children , most often girls, who have symptoms of discomfort while voiding. On examination I often directly observe a very red, irritated bottom. When I spread the labia of such a child, I can see the urine just pouring out of the introitus. I sense that the child voids and retains urine in the vaginal area, this causes secondary irritation such that burning on urination develops. The culture from such a child might show multiple bacteria, but she has a symptom (burning on urination) that is associated with UTI’s. I often see children who simply wet their pants (isn’t that a symptom of UTI?) who have been treated on multiple occasions with antibiotics for their symptom, but I am convinced they never have had a single UTI. In this case, the symptom is important and burning on urination and wet pants may not be enough for me to think that a true UTI is present. With urgency of urination and lots of bacteria on the urine specimen I might say that the particular patient may have an infection that should be treated. To gain evidence that a UTI might be present I would visually examine the urine under the microscope to look for red blood cells, white blood cells and bacteria… each is most often present with a true UTI. Interpreting the urine culture always has a page 2, and the health care provider need not necessarily dismiss a “mixed flora “ culture as negative. It may be negative, but a physical examination, careful history documenting the types of symptoms, and interpretation of the urinalysis are all necessary to make a final judgement.
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The bacterial components found are more than one type of bacteria found in the urinary and genital tract. There should be no bacteria in the urinary tract normally. There are some normal flora in the vaginal tract. Contamination from the anal area could cause urinary tract infection. So, mixed urogenital flora is a few different types of bacteria that were taken from the urinary/genital swab or culture. Depending on what’s found, your doctor will determine if you need antibiotics.
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.
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Oh yes. Here’s a passage from one of my textbooks on this:
“The large intestine harbors about 800 species of bacteria collectively called the gut microbiome. We have a mutually beneficial relationship with many of these. We provide them with room and board while they provide us with nutrients from our food that we are not equipped to extract on our own. For example, they digest cellulose, pectin, and other plant polysaccharides for which we have no digestive enzymes, and we absorb the resulting sugars. Thus, we get more nutrition from our food because of these bacteria than we would get without them. Indeed, one person may get more calories than another from the same amount of food because of differences in their bacterial populations. Some bacteria also synthesize B vitamins and vitamin K, which are absorbed by the colon. This vitamin K is especially important because the diet alone usually does not provide enough to ensure adequate blood clotting.” (Anatomy & Physiology—The Unity of Form and Function, 8th ed., McGraw-Hill 2018)
A bunch of silliness usually.
Over 50 vitamins are made by for profit motive… as all are. But the difference is largely : Packaging is different…Silver is mentioned to resonate with gray hairs etc…Pills are smaller thus easier to swallow…printing larger thus easier to read…prices cheaper.
Now what SHOULD BE DIFFERENT…
1. More herbal components and benefits of.
2. INCREASED levels OF minerals.
3. Support should include ginko, Hawthorn berrys and blueberry and bilberry extracts…B Vitamins and loads of calcium green tea extract and CoQ 10 saw palmetto.. among others.
What IS different vs. What SHOULD BE DIFFERENT are radically different from another.
