Hello, I was diagnosed with bronchiectasis about 8 years ago. I originally had pseudomonas and was treated with colomycin which supposedly has eradicated them. 7 My recent sputum sample showed two new pathogens in my lungs which my respiratory nurse said were difficult to treat. They are: Staphyloccus Aureus
and Klebsiella Pneumonias and some Thrush, She was concerned and said to start taking my rescue pack of Doxycycline and then give a further sputum sample at the end of the course for further analysis. If these two pathogens are still present following the testing of the sputum sample what further action will need to be taken?. Has anyone had any experience of these pathogens and the appropriate treatment given? Also, if they are so difficult to eradicate and are still present, what will happen next? Any advice would be so welcome as I am more than a bit worried. Thank you.
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RoadRunner44
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Hi RoadRunner44I'm sorry to hear how poorly you have been.
I have bronchiectasis, CT interstitial lung disease, pulmonary fibrosis and lupus. I had a chest infection last year which wasn't sputum tested, I was given antibiotics which didn't touch it. I can't remember what they were but a couple of weeks later I was feeling very poorly again and a sputum sample showed I had Klebsiella Pneumonia. Tests showed it was sensitive to co-amoxiclav . Not long after I had Klebsiella again and this time I was given co-amoxiclav 500 mg-125mg and clarithromycin which helped clear it up. Five weeks ago I was taken to hospital when I scored 11 on the sepsis chart, tests and x-rays showed I had a Severe Community Acquired Pneumonia in the same place on my right lung and was once again given IV co-amoxiclav, clarithromycin and fluids.
Nine days ago I tested positive for Covid and was also told to take my rescue pack of co-amoxiclav in case there was also any lingering infection from the pneumonia.
I'm sorry I can't be more help with advice on eradicating these conditions, I can only give you my own experience with Klebsiella Pneumonia. I do hope you start feeling better soon. Warm wishes Meg 🤗
Thanks so much for replying. You sound as if you have had a very rough spell and now you have Covid! I sincerely hope you r look after yourself and recover well. As for me I just hope the Doxycycline works. The specialist nurse was deeply concerned that my doctor is informed and aware of my condition to ensure the right treatment is available. My thoughts are with you too.
Ex Nurse here so I've copied and pasted this as it sums it up well ...
Staph infections are caused by staphylococcus bacteria, types of germs commonly found on the skin or in the nose of even healthy individuals. Most of the time, these bacteria cause no problems or result in relatively minor skin infections. and CelluliItis (which my Mum had in her legs and cleared up well with antibiotics ) and abscesses .Although most staph infections are not serious, S. aureus can cause serious infections such as bloodstream infections, pneumonia, or bone and joint infections.
Hi, thanks for replying. The specialist nurse was very concerned these two pathogens were found in my lungs. If the doxycycline doesnt work as she said, what will be the next step, do you know? I didn't think of asking at the time.
I'm not sure which antibiotic is used that works for the Klebsiella Pneumonaie as its a tricky bugger that usually lives in the gut. I think you could be on antibiotics for a few weeks having two bugs to be honest,
Dear RR, I know it’s a rather daunting thing to hear, but please take heart. While these can be nasty little buggers to treat, see if you can get more than a two week course of doxycycline.
I have grown both of these nasties, although not at the same time. Klebsiella requires a different medication than doxycycline, if I remember correctly.
I want to encourage you because my experience is usually that I grow stenotrophamonas maltophilia and staphylococcus aureus at the same time and often need three to four weeks of antibiotics.
One thing that has been helping me is to do a daily nasal rinse. If I keep my nose clean so to speak, my lungs are a little better off.
I have also found that wearing a mask when doing any housework that stirs up dust protects me somewhat. Both of your bugs are readily available in the environment but they love those of us with compromised lungs.
Wishing you all the best,
🕊Anne
Hello Roadrunner. These are a couple of the bugs which we bronchs get in our lungs. They have a party, grow in numbers and give us exacerbations. They need appropriate antibiotics in a high enough dose and for bronch, at least 14 days. These high doses and longer courses are most important. Doxycycline is one of the abs used against staff aurus, as is co amoxyclav.Ciproxen can be used against klebsiella, which has fewer abs which are effective and may need an even longer course. It is important that sensitivities be done for that one and really you should have your bronch specialist tackle it.This is life with bronch. The little perishers just keep coming back and in the case of pseudomonas, lurk in the lungs permanently once they have colonised, even when there are few enough numbers to show on a lab plate. Lab tests by the way are notoriously unreliable in bronch.
This is why clearing the mucus out of the lungs every day is so important because it deprives the bugs of the warm wet pools in which they like to breed.
I hope that you have a good bronch specialist. Bronch is very complex and unfortunately, GPs, general respiratory consultants and respiratory nurses do not have their expertise and experience in the condition. If the particular bacteria persist in making you poorly, there is always the option of IV antibiotics to give a good clear out, the nebulised antibiotic to keep the numbers down. Only the bronch specialist can decide and activate this which is why it is so important that you have one.
I hope that with the right abs you are soon feeling better again.
Wow! What a fantastic explanation as to the ins and out of bronchiectasis, Littlepom. Its just what I needed so that I have the tools and knowledge to deal with the situation as this is something new to me. I enjoy reasonable good health and do my best to stay that way. I like to be on top of things and the specialist nurse was particularly concerned which, in turn made me anxious. Im still under a consultant but due to Covid am only seen by the specialist nurse. I've never had Intravenous antibiotics before only nebulized colomycin.I assume IV is done in a hospital. Do you know how long it takes?
Thanks for replying I'm very grateful.
X
It is possible to do one's own IVs at home. Quite a few of us do it ourselves. I am lucky that I have not had as much IV as some but with the dear pseudomonas becoming resistant to cipro and me getting wheezy on most nebulised abs it is probably going to happen more. It is usually organised through opat teams based at hospitals. The first time you have IV would be in hospital I guess so that you get used to everything. 2 weeks should be the length of time. As it is boring sitting in hospital for 2 weeks and expensive to the NHS, it is much better to do it in the comfort of your own home.Your nurse is obviously out of her depth, as probably is your GP. These two bacteria, especially the klebsiella, need more complex treatment. Give your consultant's secretary a call and explain the situation. Ask them to ask the consultant the way to go. Consultants should tell the GP which ab to give you or that they want you in for IV. If they decide on long term nebulised antibiotic this should be delivered from the hospital too. I have recently begun nebulising meropenem and they bring the drug out to me. I only use my GP for my repeat heart drugs and cipro rescue pack. I know more than they do about my bronch and they are very cooperative with my consultant.
Bronch specialists' secs are usually very helpful. At the QE in Bham we now have a specialist bronch nurse. I can call her if I neef a message passing to my specialist. I trust nobody to decide on my treatment except my specialist.
It is one of those conditions which requires rigorous self management and proactive measures to get the correct treatment for ourselves.
Absolutely agree with LP’s comments, especially re your GP and nurse, no doubt thinking they are doing there best but you obviously do not feel and don’t appear to be properly supported. With 2 difficult positive bacteria, I would defo be in touch with my cf nurses, who have access to our consultants, for the best expert advice.
Please don’t get too concerned re IVs. Many of us do them at home, either by. Ourselves or from the community team. I finished my last course last week. It would be done in hospital first and if doing them yourself training will be given. I have a port in because of the frequency I have to have home IVs but you would just need a midline or longline.
Let’s hope the orals do the trick but please don’t hesitate to contact con if they don’t.
Good luck
Cx
Ps re doxy - one ab is not ant worse or better than another. What matters is whether they are sensitive to the bacteria you are growing. I expect you know this already though RR.
I am stunned at all the help and treatment you all have. I had my diagnosis for bronchiectasis after a lung bleed and CT scan in 2013. after 6 months the specialist transfered me back to my GP and my lungs have got steadily worse. The GP won't even do a sputum test. I don't know what to do.
The consultant you saw was obviously not a bronch specialist and just wanted to get rid of you because they didn't know how to treat you. Your GP is failing in their duty of care towards you because they know nothing about bronch. You need to be under the care of a bronch specialist and their team.the specialist decides on the ongoing treatment of this very complex condition, tells your GP which abs to give you or even treats you direct from the hospital. It is ridiculous to be discharged from a specialist because the medical needs of the condition change all the time. Only a bronch specialist is trained and experienced enough to deal with this. You should see them at least every 6 months and have contact when you are not well. I have very little contact with my GP except for repeat prescriptions for my emergency abs. My GP is grateful for my consultant being in charge.Specialists are usually at big teaching hospitals. Look on the internet, find one and take the name to your GP. INSIST on a referral. Do not take no for an answer. I keep saying - we have to be pro active in our own interests and vociferous in sourcing the right treatment. Good luck. It is your health that is important not your GPs ignorance and laziness.
You seem to have been handling it very well so far. You just need to keep on top of it - and the medics! 🤣
Best wishes for getting on top of these nasty little bugs. I only know that co-amoxiclav and clarithromycin are stronger than doxy, at least doxy did not knock out a less vicious bug I had last year.
The specialist nurse told me to contact my doctor. She will also contact my doctor with instructions naming appropriate antibiotics. As it was Friday afternoon when she rang I wasn't able to take a sample of sputum to the surgery or speak to my doctor. Under those circumstances she told me to start my rescue pack of doxicycline. I hope to get further information after speaking to my doctor. Armed with all the information I have gathered from members on here I feel my doctor will probably prefer my consultant to be imore involved. I will do what the nurse said but feel more able to ask questions now and hopefully get my consultant on board too. I appreciate your helpful reply.
Sorry don’t know the answer, but offering full support to you. I have had to send a sputum test to my hospital last week but have not had the results yet. Was placed on my rescue pack by my consultant after a horrible exacerbation a few weeks ago when on a Azithromycin summer break and am starting this again tomorrow.
Exacerbations of our condition can be so frightening Sops. Like you I hope your rescue pack works and your sputum sample is clear. Winter is approaching make sure you keep on top of things and stay well. Thanks for replying, I appreciate it.
Hi, I hope that these pathogens are not making you feel too unwell. I have recently had Staphyloccus Aureus myself which was treated with doxycycline, I am currently waiting for a second result of a sputum sample after the course of antibiotics. What the drs gave told me us that if this doesn’t cure the problem then the next step would have to be an intravenous course of antibiotics to hopefully resolve the problem. Not looking forward to that but if it’s necessary to get rid of the staph it will be worth it. I hope you get away with the doxycycline m and that it clears up. Good luck and all the best.
Yes, I hope it works too Matt. Going in to hospital for treatment at this time would be a worry as I have other underlying conditions too. Thank you for your very useful reply. Like you I hope the doxycycline works for you and your mucus result will be negative. I would be interested to know how you get on and what the next step will be in your particular case.
Hi - I’m so sorry to hear you’re feeling unwell with these 2 ‘bugs’. I have bronchiectasis and I’m currently dealing with Pseudomonas and Klebsiella together. My consultant after discussing with a consultant microbiologist has prescribed just Colomycin for 4/6 months and told me not to take any other antibiotics other than my 3 times a week Azithromycin. More sputum samples after 4 months to see what’s what! Still not feeling my best and sympathise with you. Hope you feel much better very soon and sending my best wishes.
Hello and thanks for replying. I originally had pseudomonas and nebulized Colomycin for a few years. It is probably unlikely the Doxycycline will work but I now have enough information to press ahead. I have always felt having knowledge empowers you.Thank you again.
Hi RoadRunner. Some good information you have received from several fellow sufferers. I hope that you get sorted with the IV abs soon if needed. Keep us posted. and good luck. John
Yes, i have had excellent information from members John. It certainly inspires confidence having such knowledgeable,informed friends. I am extremely grateful for everyone's input.
The findings demonstrated that garlic in all its concentrations, with both methods (disc diffusion and turbidity) and in all combinations produced remarkable zones of inhibitions against all microorganisms (Staphylococcus aureus, Klebsiella pneumoniae and Streptococcus pneumoniae).
What an interesting report TwoDrifters. I believe garlic has long been known to have many health benefits. This new research adds to its benefits. Thank you I will keep this report for future reference.
Hello RR, you have had so many detailed and interesting replies to your questions but also very interesting to me, My consultant gave me a bronchoscopy 2 weeks ago as I keep having psuedomonas and aspergillus and current treatments have not been successful. He wanted to have a good look at what was going on and said at the time that he had some excellent specimens for the lab. He is phoning me this afternon with the results and to discuss the plan going forward. Fingers crossed. Mr advice to you is to continue to be proactive, it is your health and we only have one chance to get it right.
Hi Kate, I have been so delighted with the varied, knowledgeable replies. It really has reassured me and I am so grateful. Knowing a .little of each ones experiences made me appreciate that there is definitely a difference in the care we have. Which brings me to the last part of your post as yes, knowledge is power and if we want to enjoy reasonable good health we must be proactive. So thank you for replying . I hope your telephone call is positive and your current health problem improves. Please let me know as I am interested to know what steps your journey will now take you.Cheers.
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