{"id":2821,"date":"2016-04-26T16:15:00","date_gmt":"2016-04-26T03:15:00","guid":{"rendered":"http:\/\/microbiologymatters.com\/?p=2821"},"modified":"2016-04-26T16:15:00","modified_gmt":"2016-04-26T03:15:00","slug":"enteric-flora-happens","status":"publish","type":"post","link":"https:\/\/microbiologymatters.com\/?p=2821","title":{"rendered":"“Enteric flora happens…”"},"content":{"rendered":"

Enteric flora (a mixture of bacteria of enteric origin)\u00a0causes problems for clinicians and microbiologists alike.<\/span><\/p>\n

The reporting of enteric flora from superficial swabs often triggers a prompt switch to a broad spectrum antibiotic by the clinicians, in order to cover all the possible bacterial species that one might find in enteric flora. I have seen this happen a few times over the past week, to the extent that I sometimes wonder whether this is the best way of reporting such a result…<\/span><\/p>\n

The bacteria that are found in enteric flora hardly ever cause superficial wound infections (particularly in immunocompetent patients), and even when they do, the laboratory cannot possibly be of any help here because we don’t know which one in the cocktail\u00a0is the culprit. <\/span><\/p>\n

In addition one may see a laboratory report with a heavy growth of enteric flora along with a light growth of either Pseudomonas aeruginosa<\/em>, Bacteroides fragilis<\/em><\/span><\/a>, Candida albicans<\/em> or Streptococcus agalactiae<\/em>.\u00a0However, enteric flora naturally contains these micro-organisms<\/span> anyway, so no surprise there.<\/span><\/p>\n

Just more unnecessary antibiotics for the patient…<\/span><\/p>\n

A good proportion of swabs from the peri-anal area<\/span> <\/a>will grow enteric flora. This goes without saying, and only demonstrates the relative futility of such swabs…<\/span><\/p>\n

What about sterile site cultures? When we see ‘enteric flora’ in\u00a0such areas\u00a0as peritoneal fluid or\u00a0pleural fluid, we need to strongly suspect\u00a0that faecal\u00a0material has\u00a0managed to get\u00a0in there. For example a patient with a perforated appendix will have enteric flora cultured from their peritoneal fluid, the patient with an esophago-pleural fistula will have enteric flora in their pleural fluid.<\/span><\/p>\n

This\u00a0does not mean however that we have to start\u00a0working up\u00a0every different organism in the mixture (it is faeces after all!). Only if there is clearly a dominant organism, which can certainly happen after a period of time has elapsed under antibiotic pressure, should one consider ID and susceptibilities. <\/span><\/p>\n

In summary we need to see enteric flora for what it is, and be brave enough to call it as such…<\/span><\/p>\n

Michael<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Enteric flora (a mixture of bacteria of enteric origin)\u00a0causes problems for clinicians and microbiologists alike. The reporting of enteric flora from superficial swabs often triggers a prompt switch to a broad spectrum antibiotic by the clinicians, in order to cover all the possible bacterial species that one might find in enteric flora. I have seen … Continue reading “Enteric flora happens…”<\/span> →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[3],"tags":[255,323],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p37jIp-Jv","jetpack-related-posts":[{"id":3690,"url":"https:\/\/microbiologymatters.com\/?p=3690","url_meta":{"origin":2821,"position":0},"title":"“Choosing wisely bacteriology II: Swabs from the peri-anal area”","author":"michael","date":"December 5, 2017","format":false,"excerpt":"There is so much scope for \"choosing wisely\" in general bacteriology, it is difficult to know where to start... Peri-anal swabs are rarely of value in changing patient management. That is primarily because you are swabbing an incredibly \"dirty\" area in the first place. You can be sure that your\u2026","rel":"","context":"In "The Art of Microbiology"","block_context":{"text":"The Art of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=3"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/microbiologymatters.com\/wp-content\/uploads\/2017\/12\/untitled-300x289.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":4267,"url":"https:\/\/microbiologymatters.com\/?p=4267","url_meta":{"origin":2821,"position":1},"title":"“Too much information”","author":"michael","date":"September 4, 2025","format":false,"excerpt":"Can the microbiology lab give too much information to the clinicians? Take the following hypothetical example regarding reporting of enteric type organisms: Patient X presents with acute appendicitis with perforation. They are taken to theatre for appendicectomy and peritoneal washout, and started on IV cefuroxime and metronidazole. The sample of\u2026","rel":"","context":"In "The Art of Microbiology"","block_context":{"text":"The Art of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=3"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":4157,"url":"https:\/\/microbiologymatters.com\/?p=4157","url_meta":{"origin":2821,"position":2},"title":"“Perfect is the enemy of good (microbiology)”","author":"michael","date":"January 10, 2024","format":false,"excerpt":"This quote attributed to Voltaire (\"Le mieux est l'ennemi du bien\"), rings true to me. 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