The microbial flora of the continent cecal urinary reservoir, its stoma and the peristomal skin.

The bacteria occurring in reservoir urine, on the cutaneous stoma and on the abdominal skin were studied in 9 patients who had undergone urinary diversion via a continent cecal reservoir. Aerobic and/or facultatively anaerobic bacteria were isolated persistently from reservoir urine in 3 patients but only occasionally in the remainder. These organisms were isolated in pure culture. Anaerobic bacteria also were found, although infrequently and only in conjunction with facultative anaerobes. Most stomal cultures showed heavy growth of Staphylococcus epidermidis, while fewer microbes were isolated in the abdominal skin cultures. Propionibacterium acnes, present in most skin cultures, was absent or scantily represented on the stoma. Microbial antibiosis was demonstrated in vitro between stomal and urinary reservoir bacteria in 6 patients. However, bacteria from stomal isolates had no antagonistic effect against bacteria belonging to the family of Enterobacteriacae or against anaerobic species isolated from urine. Antibiosis may influence the microbial ecology of the urine reservoir and cutaneous stoma.