Lungs Colonised with Haemophilus influenzae

[MozB]

Hi all… I have bronchiectasis and COPD and have frequent exasperations. Recently, I had a sputum test which proved positive. According to lab tests doxycycline proved effective against the bacteria. After a week of meds I had another sputum test but bugs were still there. This cycle repeated again with same result. The GP asked, have you ever had a negative sputum test???? His thoughts were that my lungs were colonised with the bacteria but not causing me a problem. At the moment, I don’t feel ill, but I do get short of breath easier, I am also coughing up more sputum than normal and don’t have as much energy as normal. Not sure what to do next and does anyone know if colonised bacteria in lungs can be eliminated.

[Patk1]

U should always have 2weeks of antibiotics with bronchiectasis. I frequently had HI before immunisation against it

[MozB in reply to Patk1]

Thanks for that Patk1… I didn’t realise you could be immunised for HI… I’ll have to look into that… makes one wonder why GP picked up on that!

[annaemmalucy in reply to MozB]

No I didn't either. Where do you live?

[LiveSalt in reply to Patk1]

Hi Patk1, is that the "stop you getting pneumonia" jab they offer when you're around 60+? or something different?

[Patk1 in reply to LiveSalt]

No it's separate and specific haemaphillus influenzae immunisation jab.i think I had two,a month apart and a mth later they check yr antibodies.do ask

[LiveSalt in reply to Patk1]

Cheers!

[MozB in reply to Patk1]

Thanks Patk1… you’re 2nd person mentioning the HI jab… will defo investigate that… hope it works for me… I can’t understand why my practice GP’s haven’t said anything before bowls.

[Heaven20]

Hi MozB, when I had haemophilus influenzae in my sputum, my doctor prescribed amoxiclav. I'm not sure about your situation of not having a clear sputum test result.The tiredness and shortness of breath is my indicator of infection, I always take for 14 days as is recommended for bronchiectasis, I hope you get it sorted and get the right prescription.

[MozB in reply to Heaven20]

…why GP didn’t pick up on that…

[peege in reply to MozB]

Some GPS are just not too bright. Whilst they're trying to prescibe fewer antibiotics they're disregarding the fact that rule is for usually healthy individuals - NOT patients with bronchiectasis, other lung diseases or other underlying health issues!!! Grrrrrr

Unfortunately we have to be our own health advocate by learning as much as possible about our own condition, this is a good place to get a bit of knowledge. Ten years ago I knew nothing, from here I've learnt enough to be as well as possible.

IE most of us here would insist on 14 days of a good antibiotic from the start, not 5 days and not 10 days. Colonising pseudonomas and haemophilus influenzae are a completely different kettle of fish. Perhaps seeing a different GP in your practice? Are you under a consultant? It is is your right to be if you have bronchiectasis under NICE guidelines.

Use the 'Related Posts ' section on the right to learn a bit more. Good luck, Peege

[MozB in reply to peege]

Many thanks for your help Peege… much appreciated. I’m sceptical about GP’s… I used to see one who was versed in respiratory but is now semi retired and works at my local hospital. The one I see now is not even a GP but a nursing practitioner… but other GP’s I’ve seen in the past don’t look into anything with any depth. But, I’m beginning to learn a lot from this site so that’s great, so, good to contact people like yourself. I’ll have a look at the NICE guidelines and see what my health centre say. Thanks again.

[MozB in reply to Heaven20]

Many thanks for that… I’ve had amoxiclav before but I don’t think for bronchiectasis… I’ll mention this to GP when at next flair up.Thank you for mentioning 14 day courses… 2 more people have said same… couple years ago I had to ask to increase to 10 days… docs should know about 14 day recommendation 👍.

[MozB in reply to Heaven20]

Many thanks for all the advice Heaven20… yes, those are the same symptoms I get when I think I might be getting an exacerbation. The other sign I’m not well (but may be a cold or virus) is nightmares and an increase in resting heart rate (displayed on my Fitbit app).I’ve had amoxiclav in the past for for an infected wound.

A few people are suggesting 2 weeks to clear infections so will defo take that up with my GP.

[Alberta56]

Hello Moz. I have bronchiectasis. About 2 years ago I had a bad infection, which was eventually traced to haemophilus. 1st sputum test didn't show it. It's a sneaky little b. It had a good hold before it was diagnosed and took a long time to get rid of. Doxycycline didn't shift it. I was eventually put on Co- Amoxiclav. When it was better I was put on Azithromycin and have been on it ever since. I don't know if the haemo is still lurking, but I haven't had an infection since. With bronch you do need 14 days of antibiotic to flush out lurking nasties.

[MozB in reply to Alberta56]

Many thanks for that… I had 2 courses of Doxy and, as said, still present… but according to lab tests it should have worked, although, as with you it may have become deep seated (good hold) so maybe needed much longer to get shut! Thanks again… really helped to focus my mind in future.

[MozB]

…why GP didn’t pick up on that…

[Mooka]

My rescue antibodies are a two week course and are in my repeat prescription so I would always have the full two weeks. Doxycycline has never helped me. Co-amiclav is my weapon of choice. GPs dont tend to know much about Bronchiectasis so he may need some direction from your consultant. I’ve had the Hib vaccination twice. Once when I was first diagnosed with Bronchiectasis and then again a few years later in the immunology clinic. I hope all the advice you have received in these posts helps you.

[MozB in reply to Mooka]

Many thanks for your help Mooka… the bacteria found thru my cultures is also HI but when I enquired about the vaccine I was told by my GP it related to something completely different and not suitable for patients with respiratory issues! But, in view of your post I’m going to delve a bit deeper. Do you have any information about the vaccines you were given that you could share?

[Mooka in reply to MozB]

royalpapworth.nhs.uk/applic...

That should help. My respiratory asked my GP to give me the HIB vaccination when I was first diagnosed with Bronchiectasis. I do recall though that HI showed up in a bronchoscope a couple of years later. Later that year I was given Menitorix during my first appointment with immunology. My GP was asked to take blood tests after 4 weeks to see if my levels had improved. Looking back at my results I can see they had improved but had dropped again by the next blood test. That maybe because I’m severely immune suppressed or that it’s not just very effective. Personally I would believe a leaflet from Papworth hospital rather than your GP who probably doesn’t understand Bronchiectasis. They give this vaccine to babies. Great advice from Charlie_G you need an experienced consultant. Good luck.

[Hidden]

As others have said, antibiotics for bronchiectasis patients are always 14 days. But in addition to this, what the report says will work and what actually works aren’t always the same. This is a well-known, medically proven fact. If you give a patient antibiotics for an infection and they’re not improving in terms of symptoms after an appropriate length of treatment, then you need to try a different antibiotic; if after 10 days of an antibiotic you’re no better at all, then that would usually indicate a different antibiotic is required.

For clarification, colonisation and chronic infection are two very different things. Colonisation is where the bacteria are present but not causing any problems at all, ever. They’re just there, hitching a ride. Chronic infection - which is a frequent occurrence in conditions like bronchiectasis, and potentially what your doctor meant (I hope!) - is where the bacteria are permanently present, but will cause problems (active infection) if numbers get out of control. Pseudomonas is a good example of this, although any infection can become chronic. People with a chronic infection will regularly culture that bacteria, even when clinically well with no changes to their respiratory symptoms or sputum. However, you still treat that bacteria if symptoms dictate that you have an active infection, you don’t just leave it. With some bacteria, like pseudo, maintenance treatment is required when well to try and keep the numbers low, but in others it’s just a case of treating flares of infection as and when they happen. Your GP can’t say you have a chronic infection (or even that you’re colonised with a bacteria) if you haven’t ever resolved the active infection to begin with. Which leads me on to my last advice.

Many people with bronchiectasis here would tell you your GP should absolutely not be leading your care. You should be under a respiratory consultant experienced with managing the condition, and they should be the ones determining what antibiotics you take and for what duration. With the best will in the world, a GP is simply not qualified to look after you properly.

[MozB in reply to Hidden]

Many thanks for the information Charlie_G… a lot to take in and a lot of useful knowledge which has clarified my understanding of infections and colonisation. I’m going to talk to my GP and see what he says about seeking the help of a respiratory consultant. I’ve been seen by one a couple of times in the past but just to deal with a particular problem at the time and not as an ongoing source of direction. It would be great to be able to speak to an expert for advice because, up to now, I feel as tho I’m on my own and self treat when I think I have an infection (which I find quite difficult to tell the difference between a cold, virus, flu etc)… and ordering Amoxycillin on repeat prescription.

[CandiR in reply to MozB]

Hi MozB. I realise this is an old post but was searching for info for myself and stumbled upon this. You have the exact same issues as myself and I was given (I’m in my 40s) the child’s Hib vaccine (called Hib/MenC) along with the pneumonia vaccine.

It was a real game changer for me, had two years relatively flare up free!

However, I’m pretty sure it’s waning now hence me coming on here to see if I should be allowed another Hib vaccine. My GP/specialist have never once mentioned a Hib antibody test before, so I’m asking for one on the good advice of the folks on here!

Good luck to you with your saga! 😊

[MozB in reply to CandiR]

Many Thanks for the reply CandiR… I’ll have to look into the Hib again with my GP… it does sound promising. I’m quite a bit older than you and haven’t had an exacerbation free year for many years.👍

[annaemmalucy]

I understood that once this has colonized in our lungs it's there for good. It does not cause me too many problems at the moment. My go to antibiotic is amoxicillin

[MozB in reply to annaemmalucy]

Thanks Anna… thank you for that… it makes sense what you say… my GO say it’s more down to symptoms to determine whether your having an exasperation but I still find it difficult to know and nearly always play safe n take the AB’s. Amoxy for me but if it doesn’t clear, Doxy…

[Patk1 in reply to MozB]

It's always hard to know the deciding point when to start rescue meds,but sooner the better once u have symptoms of infective exacerbation. Do u do lung clearance eg active cycle of breathing? With bronchiectasis u must clear mucous from lungs at least x2 ea day.do read up onlineAlso get some sample pots to have in,so u can get it tested

[MozB in reply to Patk1]

Thanks Patk1… I do n I don’t… I play plenty of sports so the need to huff n cough is present a few times a day and also after a main meal, also at night (caused by lying down for sure)… but I don’t get head down n do the stuff… I think I’ll have to start… thanks for the prompt. On a night, when in bed, chest seems clear but after 4/5 mins I feel a slight crackle and the need to huff n clear… this repeats and can last an hour or more… as tho the mucus is being continuously made!?? A few years ago was put on a long lasting bronchodilator with corticosteroid. It didn’t seem to make much difference at the time so I stopped it. I’m wondering now if the steroid would reduce amount of mucus I produce thru reduced inflammation!? I was on on Alvesco at the time… this one caused less irritation of the throat! I intend to put a question out to see how many of us, with Bronchiectasis, use a bronchodilator with corticosteroid… such as Alvesco, Trimbo etc.

[Patk1 in reply to MozB]

I'm on alvesco and fostair steroid puffersSounds like u clear chest a lot.beauty of dedicated session I think,is it helps get the bits up from lower down which can b stubborn.

R u on carbocysteine to thin it?

I sleep propped up on a few pillows

[MozB in reply to Patk1]

Right, I’ll speak to GP about Alvesco n see what he says. Yes, a dedicated session with head below feet sounds best. I play table tennis and have double for many years… picking the ball up helps move the mucus.Yes, I’m on carbocysteine as well. That does help get shut.

Using pillows sounds good altho you don’t want the neck cranked too much overnight… I was thinking about tilting the bed up at the head end by 6-10 inch!?

[Patk1 in reply to MozB]

Yes some people do that. I dont put head below feet - I was taught to lie flat on my side,tilting slightly forward in comfy position.whn I can't lie down,flutter device helps,also I do soft punches to chest and ribs to loosen it.sounds like u know what yr doing x