Does OneChoice consider the quantity of a microbe detected?

No. OneChoice does not rank treatment targets by bacterial or viral load, colony count, CT value, or a low/medium/high label. That is a deliberate design choice, not a missing feature.

Why doesn't “more detected” mean “more important to treat”?

A higher quantity does not automatically mean that an organism is causing the infection or should be treated before another organism. A common colonizer can appear in a larger amount than the pathogen that matters clinically. For example, a urine result could contain a high quantity of Lactobacillus and a lower quantity of gonorrhea; the clinically important pathogen is still gonorrhea.

Quantity can also change with specimen collection, timing, prior treatment, and the test method. Molecular tests may detect DNA from microbes that are no longer alive.

What does the evidence say?

Published infectious disease guidance reaches the same conclusion:

• The IWGDF/IDSA diabetic foot infection guideline recommends against using quantitative microbial analysis to distinguish infection from colonization, noting there is no convincing data from either conventional culture or molecular methods to support that approach. Infection is defined clinically, not by organism count.
• The AUA/CUA/SUFU recurrent UTI guideline states that no specific colony-count threshold has been shown to identify symptomatic patients at risk of progression, or those who would benefit from more aggressive antimicrobial management.
• The IDSA asymptomatic bacteriuria guideline is a useful reminder: it defines that condition using high colony counts (≥10⁵ CFU/mL) and still recommends against treatment in most populations. A high quantity is not, by itself, a reason to treat.

Why leave quantities off the OneChoice Report?

Displaying a “high” value can unintentionally steer attention toward that organism, even when it represents colonization or contamination.

This is not only a theoretical concern. A study in JAMA Internal Medicine found that raising the colony count reported on urine cultures — without changing anything about the patients themselves — sharply reduced antimicrobial treatment of asymptomatic bacteriuria, with no significant change in clinical outcomes. A diagnostic-stewardship expert panel writing in Clinical Infectious Diseases likewise recommended deemphasizing colony count as a critical component of the treatment decision.

OneChoice focuses on which organisms are most likely to be clinically relevant and which regimen covers them appropriately. Raw quantity values remain available on the source laboratory report, which is the right place to review them.

If the question is why OneChoice targeted one organism rather than another, the clinical rationale and references in OneChoice Plus answer that directly — scan the QR code on the report.