HELP-Normal Flora?

[J Berens]

dasnyder at uci.edu (David Snyder) wrote:
>In article <48dsfh$i9 at news.bu.edu>, cplclegg at bu.edu (Bruce S. Powell) wrote:
>
>> Quick question: from an eye wound exudate, is it normal to isolate S. aureus
>> and\or E.coli?  Does this indicate pathogenesis?
>S. aureus is found on the skin of many people and hence may be there
>without pathenogenisis although it is an indication of eye rubbing (which
>may not be helped if it occurs durring sleep).  E. coli may be there for a
>similar reason, however, there is the risk that those organisms will
>infect the wound.  Hence the wound should at least be watched and possibly
>lightly covered to prevent further rubbing... Of course an actual
>physician or medical microbiologist may have more to say than I, a
>wanna-be, would...
>> from urine sample: Klebsiella? (I know this is an opportunist.)
>
>I do not know if it would be alone and transiently a sign of infection,
>but I have heard of Klebsiella infections of the bladder.
>
>Hope I am more helpful than not,
>
>David Snyder
Treat the patient, not the culture.  If the eye wound shows signs of sepsis, and 
you're growing S. aureus and E. coli from a swab, therapy will have to cover them, 
even if one or both are just colonisers.  Staph aureus can commonly cause eye 
infections.

Similarly with urine cultures.  If there are features of a urinary tract infection 
and a decent urine specimen is received (with minimal urethral and external 
contamination) and you grow a large amount of Klebs (pneumoniae, probably) then it 
MAY be a pathogen; certainly treatment could then reasonably cover that isolate.  
And yes, Klebs commonly cause urinary tract infections, but is faecal flora and so 
could be present on the skin periurethrally.

John