Got a question about Pseudomonas....

[Sunny602]

Hello, Thank you in advance for your help. I am ventilator dependent, since Nov 2004 due to severe resiratory muscle weakness. I have extremely thick sputum, very hard at times to expectorate via my trach. I use Mucomyst and saline lavage to loosen things up, but bacteria still love me.  Since February, I have been suffering recurrent Pseudomonas aeruginosa, lately Pseduomonas cepacia. My doc has me on TOBI nebs (every other month), and I just went through about 3 weeks of IV Zosyn (had pneumonia). Currently, my P. cepacia is colonized with no active infection. My question is this....what is the best course of treatment of a ventilated person with chronic pseudomonas infections? I have read so many opinions about treatment. Just wondering what your thoughts are.

[National Jewish]

Pseudomonas colonization of the airways of a ventilator dependent person can be difficult to control.  Often it is impossible to eliminate.  Antibiotics, especially TOBI

[ozark]

maybe your machine should be cultured?

[bactitech]

This is a question for an Infectious Disease doctor. Hopefully, with this nasty bug, you're seeing one. I've been a med tech in microbiology for nearly 30 years. We do not isolate this organism very often. The "new" name is Burkholderia cepacia. We are currently sending ours out to U. of Michigan for further serotyping.

Are you a cystic fibrosis sufferer? Most patients that have this organism have CF.

This is not an organism to be taken lightly. I urge you to get infectious disease consultation, if you have not already gone that route. We have special procedures to follow if we isolate this bug.

[Sunny602]

Thank you Bactitect for your answer!! It is interesting that you bring up CF...my doc is suspicious that I may have a rare mutation of it, even though I am 33, but I have known some people to be diagnosed during adulthood. My initial serum testing was negative, but it only tested about 35 mutations of CF. My doc wants me to have a sweat test. I know that there are about 1300 mutations of CF, some not even discovered yet. I go to UCONN med center in June to see my pulmo, there is a great ID doc there. When I found out that B. cepacia was growing out of my sputum, I became quite concerned as well, so did my pulmo. He wasnt too surprised with the P. aeruginosa, but the cepacia threw him. Like I said, I have only been on the vent since Nov. The strain of cepacia that I have is only sensitive to two antibiotics, Zosyn was one and the other was Cipro, which I am highly allergic to. I have taken about every precaution there is when it comes to handling my vent...I use closed suction, I change my tubing as recommended, strict handwashing....Thanks again Bactitech. Sunny:)