Broth Culture Result-what's it mean?

[Paininthe*.*]

I had a broth culture result faxed to me from United Medical. The only thing that's positive is something called "Staph Coagulase Negat". Is that an actual infection, or is it normal skin bacteria...anybody know? Thanks.

[Romans8:28]

It is a skin contaminate but can cause infection. Did you do a clean catch urine or a midstream catherized urine?

[Paininthe*.*]

I did a clean catch at home, then mailed it in. I'm assuming this means there was just a bit of bacteria from my skin that contaminated the sample. Is there any way of knowing?

[Romans8:28]

Unfortunately there are really only two ways to be sure, one is to do a mid stream clean catheter urine. the only other thing would be if ii is a highly resistant staph. otherwise it is very likely a skin contaminate but there is no way to know for sure!

[PlainJane]

Hey Pain!

Did they say whether it was sensitive or resistant to many antibiotics? I remember reading here on the ICN that if the bacteria is sensitive to most antibiotics then it is more likely a contminant.

I'm sure Romans would know about that type of stuff.

Erica

[Paininthe*.*]

Yes, it said "sensitive" to all of them, except it says "resistant" to Trim/Sulfa. So I guess it's just a contaminant. Thank you ladies for giving me such great info!

[Martha13]

It my opinion if you were careful in collecting the midstream clean catch then the Staph coagulase negative is not a contaminant. Staph is the second most common finding among pathogens that can cause UT symptoms. I have been found to have it several times and always treated it with one of the antibiotics it is sensitive to - like Augmentin or Amoxicillin. It is not as pathogenic as say Enterococcus but a relatively short treatment with antibiotics is worth trying.

Ruth ****, NP, who is treating many patients with UT symptoms using a broth culture sees Staph quite often. It would be good to have her guidance in treatment and you can call and set up a consultation with her by phone.
(202-714-2415). It is always better to have a professional's help when treating with antibiotics since the dosing and choice of antibiotic is critical to successful treatment and she has lots of experience.

Feel free to email me if you have any questions. But I wouldn't just dismiss this as a contaminant.

Martha F

[ICNDonna]

What does your doctor say about the results?

Donna

[PlainJane]

Hey Pain,
Martha has given you some good advice. I wasn't trying to dismiss you I just remember going through the same thing and being told by my doc that the enterococcus that showed up on my broth was a contaminant. And I remember being told if it's sensitive to all of the antibiotics then it's more likely a contaminant. But this is not a good way to judge things you should speak to Ruth. She is very helpful.

Also, if you have bladder symptoms and the test showed infection then I figure why not treat the bacteria that showed up? That is my opinion. Wasn't trying to dimiss your results!

Good luck.
Erica

[Jo Jo]

I just had my results also and I had the exact same results "Staph Coagulase Negat". When I called them about it they said not to worry was not anything to be concered about? Anyone have any ideas about this and I did do a clean catch. Now does this mean there is an infection.:angel:

JoAnn

[Martha13]

Jo-Jo,

I would be interested to know who said "not to be concerned". A lab is not supposed to make judgements about culture results. They are only to report what they find and a professional practitioner is the one to make a decision. I have already reported that I have had the same culture result and was told to treat it which I did with success. I know others have also, and maybe some of them will respond.

Many labs are accustomed to considering Enterococcus to be a contaminant. It is an intestinal bacteria like E.coli but is often not found in the large number of colonies the labs are trained to look for. So if they do not find large numbers they just consider it a contaminant. But Enterococcus is a Gram positive type of bacteria and E. coli is Gram negative. There is a difference. Often Enterococcus does not grow on the typical 24 hour agar plate culture used by most labs. So the broth culture is used to provide a nutrient to encourage the growth of the slower-growing species which are more fastidious.

We know from a study that some people can tolerate almost any bacteria in the bladder, just as some people can tolerate H.pylori in the stomach. But if you have symptoms AND the bacteria then it is possible you have an active infection.

Martha F

[mela414]

I am interested in doing a broth culture but am on the last day of nitrofurantion for an infection. How long should I wait before I do the broth? maybe I should just call the Lab and see what they have to say. ........OH...i am actually waiting for the culture and sensitivity report from this UTI. It was not in yesterday. I gave a specimen end of day on Monday so I suspect it will be in today. I'll probably waith for those results beofe I call so that I am better informed.

[Katrina]

:grouphug: Just sending support your way as you do this!

[Romans8:28]

Mel please let us know what your current culture reports say. YOu can even PM me and I would be glad to help you to read it!

Some how my mailbox missed most of this discussion. In the beginning I really thought that the sensitivities would also show us the difference between contaminate and infection, but in our last test on me, both the hopsital and I grew out a very significant, yet also very suseptible gram. neg. bacteria. At first because of the sensitivities both my doctor and I didn't pay it as much attention as we should have. The infection/pain in my kindeys again returned. Since I was also on pain management I waited to treat it in case the pain was from inflammation or even the calcinoisis. I found my slef daily increasing my pain meds. My doctor talked to a high level pharmacist. He saw and was given all my culture reports along with the fact that the bacteria were grown in broth. His response was that this bacteria often shows itself to be very suseptible but is difficult to treat, and often shows the exact patterns of infection we are seeing! I am now on two very strong orals, 400mg Avelox & 200mg minocylcine daily with no end point given. Though this is better then the threatened IV's or daily shots in the hip! Those. At this point there are 3 different infectious disease doctors looking at my case too!
The reason they may have said to dismiss the staph. if it is suceptible to most antibiotics is because many hospitals have epidemic amounts of multiple resistant staph. so they use that as the standard as a criteria. It is very difficult to get a urine sample with no contaminates unless it is midstream clean catherize.
But if it was me I also would not just ignore it. I think I would just try a month of multiple natural antibiotics, just in case. In the test we did here all normal staph was suseptible to garlic capsule (the cheap gel kind at Wal-mart, get the ones with parsley added!!, Aloe from dessert harvest, silverbiotics, oregano oil, & echinacea was also helpful.

If after a few weeks you still FEEL like you have an infection then I would consider with my doctor the possiblity of some antibiotic treatment..., or even resend the broth culture with a clean catherized urine..., the doctor maybe more open to the results as well!

Again I am not a doctor or medical professional I am just giving you an opinion!

Shelly

[mela414]

Hi Shelly,
thanks for offering to help. I called my allergist yesterday, who was the one that found the UTI to get the culture reports. Well, guess what??? he didn't have them in. I told him to look around the office because I went in to the lab lat monday afternoon to give my specimen and it was now late firday afternoon so it should have been in. He looked around and in my chart but did not find anything. I called the lab in hopes they had the results and could fax them to him or to me.....well.............the lab was closed! It was 4:30 friday afternnoon. So, now I have to wait til monday to find out. I finished my last nitrofurantoin last night but was already having pain directly related to food. As soon as I had this homemade chicken soup ...the pain set in. I hadn't realized that although I made it from scratch I had put onions in which I didn't think I would react to. Guess what....I did!
Then after doing much research online yesterday I thought I should try to boost my immunse system with some supplements that I thought were safe. I had taken them months ago at a low dose and though I would be OK. Sure enough, the pain started in afterwards leading into the night. This morning was a killer too and although I pulled myself to get out........the pain continues to spread to my lower back and down my legs. I guess things are on fire in there. So much for trying to take supplements.
I feel that I am going around in circles and not sure who to turn to anymore. I have an appt with my PCP on monday.....who I haven't seen in about a year and minimizes everything I have. If it doesn't jump out at him off of a lab test then there is nothing for him to do. I feel my health deteriorating in so many ways but don't seem to have the type of team I need in place to help me get through this. I am hoping that although he's not my uro ...he might be able to write an RX for the broth culture. I can't get this damn bladder to heal.............and i am so sensitive to so many meds and supplements that I am having a hard time boosting my immune system........
boy..............that was a lot of rambling on my part..........:rant:

[Romans8:28]

Believe me I truly understand completely! I hope the PCP is willing to help you! Hang in there a:grouphug:! and do let me know once you get those results and I'll try to help you any way I can!

Shelly

[Fluffy2]

Mel, I hear you. There is definitely one overriding feeling I get from most of the posts I read. FRUSTRATION. If someone told me I had diabetes, I would at least feel control as there is so much known. But with this, the medical community and the lab culturing techniques seem to be behind the times and inconsistent. I have been so stressed out it is finally affecting everything.

[Romans8:28]

I think we all feel that way at times At least we have ways to communicate with one another. Many before us and had to suffer alone! I have a friend who has had IC for 20 years. She said back then no one told them anything just DMSo treatment or hydrodestention. No one even mentioned diet to her, till she came to our URO now, about 6 years ago! She really has been alone in her disease till I was diagnoised Since then I have taken helpful things to her from here!

But your right it is soo frustrating to see so much money spent and now real answers just lots of ways to cope..., hopefully we will see some improvement in the testing techniques soon! I believe communications and knowledge are the key to change, if we the patients keep asking, questioning etc. we can hope that it will in the long run effect change!

Fluffy, something interesting about the diabetes.., found this article..., I think we know less then we think about many diseases!

Infections ‘may cause diabetes’

BBC News

July 3, 2006

http://news.bbc.co.uk/2/hi/health/5134520.stm

Common infections may be a trigger for diabetes in children and young adults, research suggests.

[icbop]

Ok,

Now I have the same results as the original poster. Staph Coagulase Negat from the broth culture. I guess I could call the NP listed on the board, but since I live in Nashville I'd rather take these results to my own doctor. Will most regular docs dismiss this as a contaminate? It might be one, of course, but I did shower, do a clean catch, etc.

I seems to me that if this were a contamination, though, all sorts of junk would show up. Wouldn't it?

It is sensitive to all the antibiotics. Also, might staph such as this cause urethral burning and nothing else?

Thanks for any input!

[Moonheart]

I had a broth culture result faxed to me from United Medical. The only thing that's positive is something called "Staph Coagulase Negat". Is that an actual infection, or is it normal skin bacteria...anybody know? Thanks.


This is saying that it's negative "Negat" for Staph. The coagulase test was negative, in other words it didn't coagulate. If it had, it would have been positive for staph.

[MarthaF]

Staph coagulase negative (Staph epidermis) can be a contaminant but if you were careful in the collection it probably is not. I posted earlier in this thread about the frequency that this is found in symptomatic patients - second only to Enterococcus. The "negative " part does not mean it is not present; that is a method of differentiating this strain from other Staph.

You can ask your doctor if she/he will treat you and if not I would definitely call the NP. While doctors are not used to working with broth cultures the NP is. She is finding this often in patients who use her and she prescribes an antibiotic that is appropriate. Just because it is sensitive to many antibiotics does not mean it is just a contaminant. It seems many are not anxious to know that they may have an infection. I was glad that I was found to have an infection since that was something that could be treated. It is certainly worth trying the antibiotic route.

Martha F

[icbop]

Hello,

Yes, I'd much rather have an infection--which is treatable.

Does anyone happen to know if this is one of the ones that require long-term antibiotics?

Thanks!

[Romans8:28]

No this should not be one that calls for long term antibiotics, the staph that is scary is called MRSA multi resistant staph.

Martha is right that this one can be either a contaminate or can cause infection. The reason staph is a common contaminate is that it is normal skin flora on our skin.

I though have to say no matter how careful someone is in collection, in a broth especially it is easy to get contaminates. I personally feel that the only way to be sure that it is NOT a contaminate is to do a midstream catherized urine.

I would at least try to discuss your desire with your doctor to try antibiotic treatment, to rule out chronic infection before being diagnosed with IC. If you feel like you have an infection there is a good chance that you do. In reality even a broth culture though more accurate at finding low level bacteria still may not show an infection. These bacteria are often very hard to culture for. Chronic infection is definitely easier to treat! My doctor believes many IC patients are chronic infection patients and treats all IC/bladder symptom patients with antibiotics first! Not only that but IC patients because their bladder lining is damaged and weak are often more susceptible to bacteria. Many of his patients recover completely. Others like me the antibiotics help my chronic kidney infection but do nothing to change my IC symptoms. So I do many IC treatments.

Yes, there are side effects to antibiotics and each of us needs to consider all those things before deciding to try any treatment. I just know I am thankful that I know that I am doing what I have too. If I lived my life doing all kinds of things and taking pain meds., only to find out 10 years later that antibiotics would have relieved or even helped my symptoms, I would be angry!

[icbop]

Thanks for all the responses. I DO feel like I have an infection, but that it is not even a bladder infection. It's a urethral infection of some sort.

Yes, I do know that pain can be referred from the bladder to the urethra and have no problem with the idea in general. But, as I keep trying to explain to my uro, if it WERE my bladder, why does sitting hurt? Why when it's bad can I touch the outside of my urethra and have it hurt?

I have not yet been diagnosed with IC. Two and a half years ago these symptoms started. I went to a physician's assistant, why did a cystoscopy. He said I had urethritits. But when the antibiotics did not work and I was sent to the uro I see now, she said it was possibly IC, possibly just unexplained bladder pain. At any rate, since the 5 days of antibiotics did not work, there was no reason to look for anything else.

I took elmiron, got better for a while, but then the pain came back. I am convinced there is some sort of infection (bacterial, viral--who knows)?

Thanks for letting me vent. I was kind of hoping, as I'm sure we all do, for broth culture results not were not controversial in the medical world and that there was a treatment that led me to feel better.

I may need to travel somewhere to see one of these good docs that helps people on these boards.

Again, thanks!

[Ashelliak]

How do I get the Broth Culture!?!? :confused: :confused: :confused:

[MarthaF]

There is only one lab in the country that will do a broth culture. It is United Medical Lab located in McLean, VA. You can call and get instructions and can send a specimen on your own. It takes a week to get the results since they use a more extensive method and let it grow for several days.
The number of the Lab is: 703-356-4422.

Also, Ashley, I noticed you have kidney involvement. Romans who posted on this site earlier also has some kidney stone problems and is very knowledgeable. You could try writing her for some information about treatment. She taught herself how to do broth culturing so knows a lot about it.

Martha

[Ashelliak]

Martha-Thank you for the information! I really want to have this test done because, there are so many times that I am getting VERY ill and have very high white cell counts but, they have trouble finding the source of infection. (I know it is somewhat related to the kidneys because the left one swells). It would be very helpful for me to have the Broth culture. Thanks for the info, I appreciate it! :)

[Romans8:28]

Ashley,
Check out this website and support group. All of us on here MSK, which causes many kidney stones deep inside the kidney. Many of us suffer from flank pain even when we are not passing stones, frequent infections and the symptoms you mentioned of having infections that are unable to be cultured.
My theory, as Martha mentioned I have done lots of research and test to prove it, is that a Biofilm can actually attach to the stones in our kidneys. I have even had a biofilm researcher write a paper giving credibility to my theory and talking to my doctor. I am currently being treated by my doctor for a biofilm infection. I have given some articles links an more indepth explaination there. My user name on there is MSKShelly since I could not get the Romans8:28. Even if you don't or can't join, you can read the message boards.

http://groups.msn.com/MedullarySpongeKidney

I believe for me the bacteria and initial severe infection could have definately caused my IC but it took years before I got treatment etc. and I think the damage done to my bladder appears to be permanant. Though I would love for it all to disappear someday, the antibiotics now seem to little effect on my bladder pain or actually make it worse.

icbop, you sound like you have mainly urethral pain. I would encourage you to search urethral pain and you will find many many helpful ideas. I have also had a lot of that and have found many things, ice, heat,(I have even taken those little heat max and put the in my under clothes, lidocaine is wonderful but I am allergic to the preservatives.., MSM gel from Jacob's lab helps me soo much. I even have it compounded with lidocaine!!
Herbal baths, warm wash clothes, etc.

Then when nothing helps the pain my doctor does dilations. These do not help everyone and are uncomfortable but give me months of relief!!!

Some have also mentioned that almond milk helped them! So as you work on your infection I hope this gives you some coping tools!!

Shelly

[Ashelliak]

Shelly- Thank you so much for the information. I am def going to check it out! I keep getting infections and I just don't know why!?

[Romans8:28]

Feel free to pm me as well!

Shelly

[icbop]

Thanks so much! I'll look into the solutions. Lidocaine hurts me as well, perhaps it's the preservatives in them that do it for me too. I do have some skin allergies. I'll check out MSM!

[PlainJane]

I just sent off another broth culture today. Hoping for good news (ie no more infections!).

~plainjane

[PlainJane]

Good news! My last broth culture showed no growth.

~plainjane