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Rectal culture report of child. Any concern and what does it mean?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
Hello - My 5 month old son had a rectal culture and the doctor mailed the results to our house without explanation. It says "few epithelial cells, many gram negative bacilli, many gram positive cocci and moderate gram positive bacilli". It says "no beta strep, no salmonella, no shigella, no yersinia, no campylobacter and no enterohemorrhagic". All the "nos" sound ok but what does the other part mean? I googled and they all look like bad bacteria so not sure if I should be concerned?
Posted Tue, 22 May 2012 in X-ray, Lab tests and Scans
Answered by Dr. Hema Yadav 1 hour later
Hello ,
Thanks for posting your query.
Human gastrointestinal tract normally carries a mixed growth of various organisms or bacteria which are a part of the immunity and help in fighting the bad bacteria that enters the gut through food ,water etc.
The names which are mentioned to be absent like salmonella, shigella etc are definite pathogenic bacteria i.e bad bacteria which cause typhoid, dysentery etc So their absence indicates that your child doesn't have any major infective organism in his gut.
Now gram negative or gram positive organisms are labelled according to the staining pattern seen under the microscope, it does not say whether the bacteria are normal commensal of git or a pathogenic infective bad one .
E coli which are the most common gram negative bacilli found in human gut can be both a normal flora as well as in infection or diarrhoea.So the way doctors differentiate is by following markers,
1.Symptoms and signs of patient sugesstive of infection like blood or mucus in stools, diarrhoea, vomiting, fever, pain in abdomen etc.
2.Presence of large amount of pus cells or wbc, occult blood, XXXXXXX blood or mucus in stools.
3.A pure growth or high amount of growth of any bacteria (colony counts more than 0000) .
So according to me in your child if there are no complaints, no pus cells and a mixed growth of bacteria then this report can be considered to be normal and not worrisome .
However a rectal culture, I assume was done if he had any complaints like pain in abdomen or diarrhoea or fever etc If yes then you need to discuss its significance with respect to the clinical condition with your sons doctor.If done as a routine investigation then you need not be concerned at all.
Hope that answers your query.
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