Reporting and Normal Flora



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Reporting and Normal Flora


All organisms present in normally sterile materials are reported whether or not they are likely to be contaminants. Species known to be frequently pathogenic may be reported from normally nonsterile areas; however, when present in scant numbers, they are not necessarily clinically significant. Throat cultures, however, are routinely processed for the presence of Group A streptococci only, unless otherwise specified by the requesting physician. It is important to indicate the patient's diagnosis on the culture request slip because otherwise "normal" flora may be significant for certain groups of patients; e.g., we report any quantity of S. aureus or Ps. aeruginosa found in the sputum of a patient with cystic fibrosis. The normal flora are listed in the following table

ORGANISMS CONSISTENT WITH NORMAL FLORA

Gastrointestinal and Rectal Cultures

  • various gram-negative bacteria other than salmonella, shigella, campylobacter, aeromonas, yersinia, edwardsiella and vibrio species

  • non-dextrose-fermenting gram-negative rods

  • enterococci

  • Staphylococcus epidermidis

  • alpha-hemolytic and nonhemolytic streptococci

  • diphtheroids

  • Staphylococcus aureus in small numbers

  • yeast in small numbers

  • anaerobes in large numbers

Genital Cultures

  • Any amount of the following:

    1. corynebacterium species

    2. lactobacillus species

    3. alpha-hemolytic and nonhemolytic streptococci

    4. nonpathogenic neisseria species

  • The following when mixed and not predominant:

    1. enterococci

    2. enterobacteria and other gram-negative rods

    3. Staphylococcus epidermidis

    4. Staphylococcus aureus

    5. Gardnerella vaginalis

    6. candida species and other yeasts

  • Anaerobes (too many species to list) - the following are reported

    1. when predominant or in pure growth:

    2. prevotella species

    3. clostridium species

    4. peptostreptococcus species



Oronasal (oral, nasal, and pharyngeal) Cultures

  • Any amount of the following:

    1. diphtheroids

    2. nonpathogenic neisseria species

    3. alpha-hemolytic streptococci

    4. Staphylococcus epidermidis

    5. nonhemolytic streptococci

    6. anaerobes (too many species to list; varying amounts of bacteroides species, anaerobic cocci, diphtheroids, fusobacterium species, etc.)

  • Lesser amounts of the following when accompanied by the above:

    1. yeasts

    2. haemophilus species

    3. pneumococci

    4. Staphylococcus aureus

    5. gram-negative rods

    6. Neisseria meningitidis

Skin Cultures

  • Staphylococcus epidermidis

  • Staphylococcus aureus (in small numbers)

  • micrococcus species

  • nonpathogenic neisseria

  • alpha-hemolytic and nonhemolytic streptococci

  • propionibacterium species

  • small numbers of other organisms (e.g., candida or acinetobacter species)

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