Quest Standard vs special culture

[mich2604]

As some of you know, I had the special culture done last month and the results showed staph and enteroccocus species at a count of 50,000-100,000.
I have not treated for this yet, because I have my appt with my dr this tuesday(not my urologist office) and want to see what he has to say.

My urologist office ran the standard Quest culture when I was having horrific bladder symptoms two weeks ago....the results showed numerous bacteria ALL under 10,000, bacteria found on the normal genitalia, so they were colonized bacteria.

I just dont understand how One culture shows high amounts of bacteria and the other doesnt. My only guess is they ignore the staph and entero during the standard cultures.

I will bring this up with my dr next week. Im just trying to make sense of it all.

[MarthaF]

Mich,

Thanks for posting this information. Very few that we know of have used the Quest "special" culture and we need to hear about it. I tried to talk to the lab tech about it but they will only talk to MD's. I think Quest has regional labs that do these cultures and I think they all may have their own method. It appears some use different culturing media and some just let the regular agar plate grow longer and report ALL growth.

Some species take longer to grow out and are difficult which is why Dr. Fugazzotto used a broth first and that encourages the growth of something like Enterococcus. This entails some extra steps and expertise and I suspect the large lab corporations will not invest that time. But it seems Quest is finding and reporting low colony counts, as in your case. I think they have considered these to be contaminants in the past and the microbiologist at a large urology center told me they just discount Enterococcus as a "contaminant". But if a patient is having symptoms it could well be this bug. The colony count is not a hard and fast "rule", just something a doctor established 50 years ago for E. coli. Other species do not necessarily grow to such large numbers, but most medical/lab personnel have been trained to look for large numbers of E. coli to declare a UTI.

Shelly taught herself to culture and so has first-hand experience and I hope will chime in here. It would be great if we could depend on the Quest culture since they are all over the country. I don't think most MD's know about their "special" culture and have always assumed the "routine" was dependable.

Martha F

[Romans8:28]

Allowing the culture to grow longer and using different media does make a big difference.
Stnadard cuturing is done to save both time and money not to find every possible bacteria unfortunately..., and to a certain extend you get only what you look or culture for. Different bacteria grow on different media and also at different temperatures. Quest must uses some extra culture plates..., I think someone also mentioned they use a large loop which is more likely to pick up low level bacterial infections!

Martha is right that many things are often disregaurded as contaminates that can actully cause infection especially in the weakened IC bladder lining!

the problem is that contaminates really can be a problem...., it is hard to get a pure culture from there, mid stream clean catch helps, having just taken a shower before collection helps too.

The only way that they can be sure it is not a contaminate is to:
Treat based on symptoms

or to do a mid stream catherter collected urine.

Hope that helps!

Shelly