Skin Flora
Despite many reports of contamination with bacteria commonly associated with skin flora, the WHO only gives the general recommendations of strict hygiene and passage of urine before producing semen sample by masturbation.[1] One study suggests that skin flora contamination may be unavoidable, since as much as 71% of the bacterial strains colonizing the coronal sulcus are also present in the distal urethra.[22] The ability of skin flora to inhabit the urethra was also suggested by a prospective study that found that the majority of positive cultures contained gram positive bacteria from first-catch urine, midstream urine, and semen samples.[21] This study found no significant difference in the presence or absence of bacteriospermia or leukocytospermia in achieving pregnancy.[21] Similarly, a retrospective study found no significant difference in the IVF rates between cultures that grew skin contaminants and those that were growth free.[23] The presence of skin flora within semen cultures may be unavoidable and appears to lack clinical significance.
A summarization of the mode of detection and effect on semen parameters for each group of organisms is presented in Table 2.
Transl Androl Urol. 2017;6(5):916-922. © 2017 AME Publishing Company
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