You have just been reading a urine culture…
Looking at all the evidence; 20 (million/l) leucocytes only, a light growth of 2 different organisms, no clinical details provided, lots of epithelial cells present.
Deep down you strongly suspect these isolates are not significant, but the temptation is still to report the isolates with susceptibilities, “just in case” it really is a genuine UTI.
The report comes for authorisation. A second chance…
However the same urges remain. “I think this is probably rubbish, but someone else doesn’t think so. I’ll just report it out in case it is significant.”
I am as guilty as anyone else of this type of over-reporting, which can potentially affect a wide range of different sample types. However the same principles apply regardless of what is being tested.
Our basic instinct is to help the patient, to get the result, to find the cause of the illness. However sometimes such instincts lead to over-reporting, with the potential for misdiagnoses, over-treatment and antibiotic resistance through increased selection pressure.
Microbiology dogma dictates that under-reporting is a worse crime than over-reporting.
I disagree, and I love to challenge dogma.
Sometimes we need to be brave, take all the evidence into consideration and then let our brain rather than our heart make the call.
And sure we will get it wrong from time to time.
But then again, no one ever always gets it right…