I need advice about klebsiella oxytoca please?

[star68]

I went to thee doctors for a routine check up, no symptoms just post nasal drip due to my chronic sinusitis, and he send me to do a culture of my sputum. The results came back as follows:
We observe >10 leukocytes and <25 epithelial cells 100x field
We obtain abundant growth of Klebsiella Oxytoca.

The doctor prescribed antibiotics cefuroxime 500 twice a day for 10 days to deal with the bacteria.  If I had no symptoms why did he prescribed antibiotic?
I have read on the internet that this bacteria is very resistant to antibiotics and they say it can cause havoc in your body. My doctor didn´t go into details so I was not informed therefore I panic every time I read about the bacteria. I don´t know whether is in my stomach, sinuses, lungs? How dangerous it is, and as I said I didn´t have any symptoms if I wouldn´t have gone for a routine test they would have never found it and what would have happened? Or maybe I had it for years. I have tried to research on the internet before asking here but I couldn´t find anything that answered my questions in fact as mentioned everything I read is very demoralizing.  Could someone that knows about it inform me about this bacteria. Many thanks in advance.

[Apollo14]

Dear Star
there any update.
i' m on cefurxim with klebsiella oxytoca right now.
day7 and my sinsitis is not better yet

Take care

[star68]

I really appreciate your support, I will wait for my results and I will make sure the antibiotic is suitable for me.  I will keep you posted.

Thanks again!!

[mkh9]

No,you don't want to take cipro if you are having a problem. There are other drugs you can take. So you can get treatment. I understand your fear. K. oxytoca doesn't turn into K. pneumoniae. They are two different organisms. They can both cause pneumonia depending on your immune system. That is probably what you meant though right? Try not to worry.
hang in there,
mkh9  

[star68]

I think I had more of a reaction to cefalosporins but Doctors don't want to risk it, they ask you to suspend treatment in case you are building an allergy reaction.  It's like with the aquiles tendon straight away he asked me to suspend it.  I am worried because if this cold turns into Klebsiella P. I am in trouble.  Surely is less harm rupturing your aquiles tendon than contracting pneumonia?  I am not clear about that one. Sometimes I feel like carrying on taking it.

[mkh9]

If you are allergic to the cefalosporins then you may be allergic to penicillin. Cefuroxime is in the same class. I guess I said that before. So, be careful and ask the doctor about that. You may want to be near the doctors office for a while after the first dose. BTW, penicillin itself doesn't work on K. pneumonia. So, he must be thinking of one of the drugs that are in the same class that work on Klebsiella. Also, for a cold (not the flu) zinc lozenges will help inactivate it.
mkh9

[star68]

Nice to hear from you I can't thank you enough for all the advice you are giving me.   Now I have to wait a couple of days just to get rid of the antibiotic I took and do the test again.  I will let you know how everything progresses I am just keeping my fingers cross that my cold doesn't end up K.Pneumonia that is my biggest fear I am trying to take a lot of vitamin c to reinforce my immune system, and try another antibiotic.  Hopefully I am not allergic to pellicin and can start taking it again.   I will keep you posted.
Speak to you soon!!

[mkh9]

Hi star68,
So sorry about your sister but glad she is doing better and your  mom. I hope she does well with her surgery.  Yes Ciprofloxacin is known for causing tendonitis and even ruptured tendons. I refused to take it because I already have tendonitis. So they didn't give it to me. It should go away since they took you off of it. You need to get lots of rest if you can. They really need to test that Klebsiella to see what it is resistant to. I hope they do. Sorry you still have it. I would get to the doctor now that you can and get them to test you. Sorry you are going through all this.
mkh9

[star68]

Hello again,
How are you?  I hope you are well.
Sorry I haven't been in touch sooner but I had my mother in hospital and my daughter had surgery of the ovary to remove a cyst, she is fine but my poor mum needs an open heart operation so it has been quite worrying but she's going ahead with it and my sisters and I have decided is for the best.
I repeated the test two week ago and the klebsiella showed up again.  The Doctor decided to give me Ciproflacine 500g every 12 hours.  Two days into the treatment I have developed a pain in the achilles tendon and my back, rang my Doctor and he said to suspend treatment again!!  He said he will test my blood for allergy to pellicin test my sputum again and we will see after that.  After reading the internet about Cipro I cannot believe this medication still on the market, the amount of side effects and worse rupture of the achilles, but the histories out there horrendous.
The problem now is that I am terrified about my immune system running low and klebsiella affecting me.  In fact I have  a cold now, I really hope it doesn't progress any further.  I am a bit fed up with it to be honest, I really don't know where I stand now.  

[mkh9]

Ok look forward to hearing from you. I doubt you are  allergic to the antibiotic but rather had a reaction. But you never know. I am allergic to a lot of topical antibiotics and never been tested. If you are allergic to penicillin it is related to the cephalosporin group of antibiotics (Cefuroxime is related to group because they are all beta lactam drugs). So, I am curious how they test you for it because my brother is very allergic to penicillin. Would you let me know.
Yes you should get your culture done again and then if still positive see what the doctor says.
take care,
mkh9

[star68]

Yes you are very right I have followed the Doctor's advice and have stopped taking the medication.  He never gave me another antibiotic I suppose he wants to do another culture to see if the bacteria still in my system (which I think it is) and then try with another antibiotic.  In the meantime I am going to go to the allergy Doctor to see if I am allergic to Cefuroxime.  
Thank you so much about your answers it has made me understand more about my condition, I will keep you posted.  All the best xx

[mkh9]

Well, there isn't much you can do about it now. I think the main thing is that for the drug cefuruoxime, the bug may or may not have become resistant to that. So, you have to wait and see if your culture results come up positive again. Hopefully they are negative this time. They usually give you more than you need but you did cut it off pretty soon. 7 days would have been better. If the Klebsiella is gone then you won't have to worry about it. If you ever get it again bring up what happened to the next doctor and they won't give you that antibiotic. I have had to go off antibiotics sooner than planned due to yeast or some other problem. You should be ok. They may just alter the meds next time if needed. Hope this helps.
Apparently, the doctor didn't like the side effect so it is best to follow that advice. It could have been a precursor to allergy. Hard to know for sure.
mkh9

[star68]

Thank you mkh9.  I had to take the antibiotic twice a day, I have only done half cycle the course was 10 days and I only done 5 days and a half.  There are 10 sachets in per box so I have done 11 sachets.  I stopped the medication on Saturday at 11 o´clock and saw the Doctor Sunday at 10 o´clock 24 hours since my last dose.  I said can I carry on are my side effects so important, and he just said don´t take it anymore we will repeat the culture in a week´s time and then will see.  My concern is that I didn´t take the  antibiotic long enough to kill the bacteria and a result the bacteria might become stronger and more difficult to get rid off.  Thanks.

[mkh9]

I looked up the side effects for Cefuroxime and sweating, fever, chills, were side effects of the drug. They just say consult your doctor if you have any these and a number of other side effects. I can't say what you should do since I am a microbiologist not a doctor. So, it is up to you on that end. I can only answer your questions. In the U.S. they screen Cefuroxime and other Cefalosporins for AmpC beta lactamase producing Cefuroxime and other resistance mechanisms. I don't know about other countries. Are you in the UK? They may or may not check for this and may just take you off the drug or not put you on these. If it is on their formulary (it must have been or the doctor that gave you the drug would be liable) then I don't see why the other doctor would say that it wasn't. Or how do they treat in your country? If they have an antibiogram (as we do) then it doesn't sound right what that doctor said. I can't imagine a doctor going by Wikipedia. That is not the way doctors are supposed to get their info. He sounds like an intern. IT doesn't make since that he said it has been 24 hours since your last dose. Does that mean it has been too long? Are you taking them once a day or several times a day? If several times a day then you haven't been on the right dose too. You can also ask a pharmacist or chemist about that. I would definitely follow up again once you stop the dose but wait a week so the antibiotic gets out of your system and doesn't interfere with the test.
mkh9

[star68]

Thank you again for answering my questions you have been very helpful.  Sorry to be a pain but now I have new doubts.  While taking the antibiotics I have been having intermittent hot flushes not much sweating but intense heat feelings(the don´t mention this side effect in the information pamphlet.  It only says that can make the contraceptive pill less effective because it lowers the estrogens levels.  As I am 45 and even thought in a blood test shows my hormone levels are OK I still think I have perimenopause symptoms hence the more intensified hot flushes.  
I already took 11 sachets of the Zinnat 500 (Cefuroxime) and last night I decided to search about the heat feeling as a side effect on the internet.  Someone mentioned it could be an allergic reaction to the antibiotic and instructed me to call the Doctor.  I rang the surgery and the Doctor said not to take it and go and see my Doctor.  I went today and explain everything to the Doctor and he said not to take it anymore he never gave me a different antibiotic and he said to repeat the sputum culture in one week.
Now I am aware about antibiotic resistance and as I have only taken 5 days and a half of the antibiotic I am worried that the klebsiella is going to come back and it will be stronger more resistant and more difficult to fight back.
He then looks in Wikipedia and says that Cefuroxime is not recommended regardless the in vitro drug sensitivity.  But the antibiogram said Cefuroxime was in  the susceptibility chart.  I am very confused and very angry because the don´t  take the antibiotics intake seriously and that is way bacterias are so resistant.  I said to him I will put up with the heat feeling if it´s not dangerous and take the next dose but he said no there´s no need because it´s been 24 hours since my last dose.  Please could you help me again??  Thank you sooo much.

[mkh9]

Well, the doctor may have heard something when he listened to your lungs (if he did). In this case because they said your sputum had abundant K. oxytoca and the specimen was a good one (>10 leukocytes, 25 leukocytes,<10 epi but that is ok. Did they say that no other organisms were seen? If they said nothing else I would assume that is all they found. So, if you find abundant growth of an organism that can cause bronchitis or pneumonia in a area where it does cause that disease i.e. the lung then you should take the antibiotic. Taking less the full dose will create resistance. So, don't worry about taking one antibiotic. You can take a probiotic with it if you like. You can get one at Costco or some other store that has several different types of bacteria such as bifidobacteria, lactobacillus, and so forth. You may have contracted it by going to the hospitals and touching your face possibly if it wasn't too long ago. Bacteria can hang around in smaller numbers along with your normal flora (normal bacteria) in your lungs and wait until you get run down or it is possible that you have the same bacteria in your nose and you got it that way. Did they culture your nose? Usually, you get Staph infections in the nose but I have seen other things but not usually Klebsiella. Klebsiella can get into wounds and usually doesn't spread around but then if you happened to get it in your nose then carried it around then it got into your lungs. It is really hard to say. Do you know what the biopsy wound was infected with? If you don't feel run down I wouldn't worry about working. Usually, they say that people who work in hospitals (I used to work in several for many years and rarely got sick) have a higher immunity. The only think to worry about is MRSA (staph that is resistant as you probably have heard of). Also, some times you can contract Clostridium difficile if you are working with patients. Just don't touch your face and wash your hands well before eating there or before leaving. I don't like taking a lot of antibiotics either. But you shouldn't have a pure culture with a large number of bacteria in it and you have a sinus infection.  I think I would take it this time. Just be more diligent about washing your hands and clothes after you leave and when you get home. does this help? I mean I worked since 1980 in the hospital first as a phlebotomist , then lab assistant through college then a microbiologist for 20 years. I got strep throat on the job twice in all that time. It may not have been from work either. Let me know if you have any other questions. Try not to over worry.
take care,
mkh9

[star68]

Thank you so much for your answer.  Yes I will have to see my Doctor a month after the treatment is finished to repeat the culture. I have lots of questions about the bacteria.  
Why do I have to take antibiotics if there are no symptoms?
What would have happened if I didn´t have the culture and didn´t take antibiotics?
Personally I don´t like to take antibiotics especially if there are no symptoms. I am taking them because I didn´t know much about the bug so I got worried. But now I have my doubts, maybe I shouldn´t have rush to take them repeat the culture and consult with a doctor my concerns.
And how long has the bacteria been in my system?  
I would like to know how I contracted the bacteria.  I have to go to hospitals regularly because of my job(I am an Interpreter-Translator) and I wonder if I have caught it in the hospital, I can´t think any other way because I haven´t had surgery I only had a biopsy of the skin a year ago that got infected and I had to take antibiotics and go to hospital everyday for 10 days to have it cured, perhaps I got it then and has been in my system all that time.  I don´t know anymore  Now I am afraid to go to work I keep thinking I might get other illnesses because of my job.

[mkh9]

Hi, yes I think that your doctor is probably treating you because you have chronic sinusitis and so when he listened to your lungs maybe he heard something or he may just be treating to get rid of the chronic sinusitis. They often treat just In case (empirically) to prevent pneumonia. Since you had K. oxytoca, which is almost identical to Klebsiella pneumonia in the way it causes disease and its resistance patterns to antibiotics etc. These two bacteria can cause pneumonia. It can cause other things too if they had found it say in a wound. But they didn't and you don't have a wound infection. You see what I mean? I wouldn't freak out about it since you only have the sinusitis and/or it is in your sputum. You don't have a high fever do you? Do you have a bad cough or trouble breathing like you would with pneumonia? So, I would finish the course of antibiotics and take it easy and see how you feel after they are done. I hope it clears up the sinusitis. The problem some people have is when they are not given the right antibiotics when they need them. The labs are required to do certain tests to check if the bacteria are resistant or not. They are aware of these types of bacteria and know to test for this. I hope this helps. If you have any questions feel free. I hope I have answered your questions. Also, don't drink alcohol with that antibiotic as it may make you nauseated. Do you have a follow up appointment with your doctor?