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Dr Patel
Dr Patel, Doctor
Category: Medical
Satisfied Customers: 866
Experience:  12 years of experience in the health care field
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gram-positive flora

Resolved Question:

I had a urine culture taken and it said gram-positive flora,which was mixed with different kinds of bacteria. I am on my 5th antibiotic since Feb. 24. Please explain what this means. Thank you.
Submitted: 8 years ago.
Category: Medical
Expert:  Dr Patel replied 8 years ago.


It depends on how much bacteria is growing; if it is more than 100,000 colony forming units its indicative of infection; less than that indicates contamination from collection of the specimen


A urine culture is our gold standard test to see if you had an infection. A urine culture should be obtained before you start any antibiotics, even though this is hard to do so. If you did in fact have a culture proven UTI, the second reason to have a culture is that we can find the right antibiotic. So the first two steps are to make sure you are infact having infections and second that it is being treated appropriately. I would really encourage you to not take antibiotics until a culture is sent so that you will know what antibiotic is appropriate. Antibiotic resistant organisms are a problem these days bred by improper antibiotic choices.


We divide recurrent UTIs into anatomic/structural abnormalities and functional abnormalities.


Anatomic abnormalities include kidney swelling, prostate abscess, and stone disease. This can be evaluated with a good rectal exam, CT scan of the abdomen and pelvis with and without contrast, and cystoscopy (telescope inside your bladder).


Functional abnormalities include high pressure voiding or incomplete emptying of your bladder. Recurrent infections in men are often due to incomplete emptying of the bladder or high pressure voiding and these are best checked with a urodynamic study (pressure flow study done by a urologist to see how your bladder fills and empties) and voiding cystourethrogram (contrast study by radiology to see how your bladder empties).


If you have not had imaging of your kidneys, cystoscopy, and a urodynamic study, it may be wise to consider.


Best of luck,
Dr Patel


Customer: replied 8 years ago.
A year ago I had CT scan, MRI and cystoscopy done when I had infections. They found that I have horseshoe kidneys with cysts on them. Could this infection that I'm having again now, have anything to do with the kidneys themselves? Since Feb. 24th, I have been on 10 day seiges of these antibiotics with UA's taken between each batch of antibiotics. Feb.24-Mar.6 Nitrofurantain; Mar.16-Mar. 26 Ciprofoloxine 250 mg.; Mar.30-Arpil 9 Sulfamethoxazole; April 15-April 25 Ciprol 200 mg 2x daily;Yesterday April 29-May 8 I will be taking Levaquin 500 mg. once a day. I sure hope the Levaquin will clear this up and I never have this again. It's sure no fun. Thank you so much for your reply it is helpful.
Expert:  Dr Patel replied 8 years ago.


Unless the kidneys have a blockage (would have been evident on CT scan) it is unlikely these are the cause of infections- again, it is important to make sure you have a culture before starting antibiotics otherwise you will have many resistant organisms that will be impossible to treat with oral antibiotics


Best of luck,

Dr P

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