Antibiotic Resistance

[etabetac]

The test Karen is mentioning is called a synergy testing to determine what antibiotics will work on the bug that's being cultured. But you mention that all she is culturing is staph currently. So this is why I assume your doctors are asking if you want to treat or not because they do not know what bug is causing the problem since the one they can see is mild. When they test for bugs (i.e. PA, S. Malt, Staph) are they doing a throat swab or a sputum culture? If they are doing anything but a sputum culture you need to make sure you get a sputum culture. This is the most accurate you will get without doing a bronchoscopy. The sputum culture can then be tested for sensitivities/synergy. If your child has trouble getting up sputum, the clinic can do a sputum induction using hypertonic saline. Your doctor may also let you do this at home (but I think that depends on the doctor).

S. Malt is naturally resistant to several combos of drugs. There is a need for more research. But I'm not sure if your daughter's is resistant to all or just some. Some resistance is not as big of a deal because there are some drugs out there that do work. Among those are aztreonam/clavulanic acid, ticarcillin/clavulanic acid, newer fluoriquinolones. S. malt. responds best to the following drugs: Ceftazidime, Gatifloxacin, Levofloxacin, ticarcillin/clavulanic acid, and Trimethoprim/sulphamethoxazole. Less than 50% of all s. malt are resistant to these and in the case of Tri/Sulph and Tic/Cla 90% of s. malt is sensitive to these. Also sometimes just because a bacteria doesn't respond on a slide doesn't mean it won't respond in the body.

Are you all using pulmozyme? Using the vest? Getting the sputum from her lungs?

I'd also think about the possibility that there's an asthmatic componenent, gerd, or some allergies going on. Your child has had a huge drop and a very quick one so it needs to be handled and gotten to the bottom of or that damage can become permanent. The last bit of advice is if you are close to a major university teaching hospital is to get in contact with infection disease to see what advice they have.

 

[etabetac]

The test Karen is mentioning is called a synergy testing to determine what antibiotics will work on the bug that's being cultured. But you mention that all she is culturing is staph currently. So this is why I assume your doctors are asking if you want to treat or not because they do not know what bug is causing the problem since the one they can see is mild. When they test for bugs (i.e. PA, S. Malt, Staph) are they doing a throat swab or a sputum culture? If they are doing anything but a sputum culture you need to make sure you get a sputum culture. This is the most accurate you will get without doing a bronchoscopy. The sputum culture can then be tested for sensitivities/synergy. If your child has trouble getting up sputum, the clinic can do a sputum induction using hypertonic saline. Your doctor may also let you do this at home (but I think that depends on the doctor).

S. Malt is naturally resistant to several combos of drugs. There is a need for more research. But I'm not sure if your daughter's is resistant to all or just some. Some resistance is not as big of a deal because there are some drugs out there that do work. Among those are aztreonam/clavulanic acid, ticarcillin/clavulanic acid, newer fluoriquinolones. S. malt. responds best to the following drugs: Ceftazidime, Gatifloxacin, Levofloxacin, ticarcillin/clavulanic acid, and Trimethoprim/sulphamethoxazole. Less than 50% of all s. malt are resistant to these and in the case of Tri/Sulph and Tic/Cla 90% of s. malt is sensitive to these. Also sometimes just because a bacteria doesn't respond on a slide doesn't mean it won't respond in the body.

Are you all using pulmozyme? Using the vest? Getting the sputum from her lungs?

I'd also think about the possibility that there's an asthmatic componenent, gerd, or some allergies going on. Your child has had a huge drop and a very quick one so it needs to be handled and gotten to the bottom of or that damage can become permanent. The last bit of advice is if you are close to a major university teaching hospital is to get in contact with infection disease to see what advice they have.

 

[etabetac]

The test Karen is mentioning is called a synergy testing to determine what antibiotics will work on the bug that's being cultured. But you mention that all she is culturing is staph currently. So this is why I assume your doctors are asking if you want to treat or not because they do not know what bug is causing the problem since the one they can see is mild. When they test for bugs (i.e. PA, S. Malt, Staph) are they doing a throat swab or a sputum culture? If they are doing anything but a sputum culture you need to make sure you get a sputum culture. This is the most accurate you will get without doing a bronchoscopy. The sputum culture can then be tested for sensitivities/synergy. If your child has trouble getting up sputum, the clinic can do a sputum induction using hypertonic saline. Your doctor may also let you do this at home (but I think that depends on the doctor).

S. Malt is naturally resistant to several combos of drugs. There is a need for more research. But I'm not sure if your daughter's is resistant to all or just some. Some resistance is not as big of a deal because there are some drugs out there that do work. Among those are aztreonam/clavulanic acid, ticarcillin/clavulanic acid, newer fluoriquinolones. S. malt. responds best to the following drugs: Ceftazidime, Gatifloxacin, Levofloxacin, ticarcillin/clavulanic acid, and Trimethoprim/sulphamethoxazole. Less than 50% of all s. malt are resistant to these and in the case of Tri/Sulph and Tic/Cla 90% of s. malt is sensitive to these. Also sometimes just because a bacteria doesn't respond on a slide doesn't mean it won't respond in the body.

Are you all using pulmozyme? Using the vest? Getting the sputum from her lungs?

I'd also think about the possibility that there's an asthmatic componenent, gerd, or some allergies going on. Your child has had a huge drop and a very quick one so it needs to be handled and gotten to the bottom of or that damage can become permanent. The last bit of advice is if you are close to a major university teaching hospital is to get in contact with infection disease to see what advice they have.

 

[etabetac]

The test Karen is mentioning is called a synergy testing to determine what antibiotics will work on the bug that's being cultured. But you mention that all she is culturing is staph currently. So this is why I assume your doctors are asking if you want to treat or not because they do not know what bug is causing the problem since the one they can see is mild. When they test for bugs (i.e. PA, S. Malt, Staph) are they doing a throat swab or a sputum culture? If they are doing anything but a sputum culture you need to make sure you get a sputum culture. This is the most accurate you will get without doing a bronchoscopy. The sputum culture can then be tested for sensitivities/synergy. If your child has trouble getting up sputum, the clinic can do a sputum induction using hypertonic saline. Your doctor may also let you do this at home (but I think that depends on the doctor).

S. Malt is naturally resistant to several combos of drugs. There is a need for more research. But I'm not sure if your daughter's is resistant to all or just some. Some resistance is not as big of a deal because there are some drugs out there that do work. Among those are aztreonam/clavulanic acid, ticarcillin/clavulanic acid, newer fluoriquinolones. S. malt. responds best to the following drugs: Ceftazidime, Gatifloxacin, Levofloxacin, ticarcillin/clavulanic acid, and Trimethoprim/sulphamethoxazole. Less than 50% of all s. malt are resistant to these and in the case of Tri/Sulph and Tic/Cla 90% of s. malt is sensitive to these. Also sometimes just because a bacteria doesn't respond on a slide doesn't mean it won't respond in the body.

Are you all using pulmozyme? Using the vest? Getting the sputum from her lungs?

I'd also think about the possibility that there's an asthmatic componenent, gerd, or some allergies going on. Your child has had a huge drop and a very quick one so it needs to be handled and gotten to the bottom of or that damage can become permanent. The last bit of advice is if you are close to a major university teaching hospital is to get in contact with infection disease to see what advice they have.

 

[etabetac]

The test Karen is mentioning is called a synergy testing to determine what antibiotics will work on the bug that's being cultured. But you mention that all she is culturing is staph currently. So this is why I assume your doctors are asking if you want to treat or not because they do not know what bug is causing the problem since the one they can see is mild. When they test for bugs (i.e. PA, S. Malt, Staph) are they doing a throat swab or a sputum culture? If they are doing anything but a sputum culture you need to make sure you get a sputum culture. This is the most accurate you will get without doing a bronchoscopy. The sputum culture can then be tested for sensitivities/synergy. If your child has trouble getting up sputum, the clinic can do a sputum induction using hypertonic saline. Your doctor may also let you do this at home (but I think that depends on the doctor).
<br />
<br />S. Malt is naturally resistant to several combos of drugs. There is a need for more research. But I'm not sure if your daughter's is resistant to all or just some. Some resistance is not as big of a deal because there are some drugs out there that do work. Among those are aztreonam/clavulanic acid, ticarcillin/clavulanic acid, newer fluoriquinolones. S. malt. responds best to the following drugs: Ceftazidime, Gatifloxacin, Levofloxacin, ticarcillin/clavulanic acid, and Trimethoprim/sulphamethoxazole. Less than 50% of all s. malt are resistant to these and in the case of Tri/Sulph and Tic/Cla 90% of s. malt is sensitive to these. Also sometimes just because a bacteria doesn't respond on a slide doesn't mean it won't respond in the body.
<br />
<br />Are you all using pulmozyme? Using the vest? Getting the sputum from her lungs?
<br />
<br />I'd also think about the possibility that there's an asthmatic componenent, gerd, or some allergies going on. Your child has had a huge drop and a very quick one so it needs to be handled and gotten to the bottom of or that damage can become permanent. The last bit of advice is if you are close to a major university teaching hospital is to get in contact with infection disease to see what advice they have.

 

[etabetac]

Just wanted to say that I don't know that much about s. malt. but am quite good at reading the research on it because of my research background. So I actually don't think I can answer a lot of questions about it just help you interpert what I've read.

 

[etabetac]

Just wanted to say that I don't know that much about s. malt. but am quite good at reading the research on it because of my research background. So I actually don't think I can answer a lot of questions about it just help you interpert what I've read.

 

[etabetac]

Just wanted to say that I don't know that much about s. malt. but am quite good at reading the research on it because of my research background. So I actually don't think I can answer a lot of questions about it just help you interpert what I've read.

 

[etabetac]

Just wanted to say that I don't know that much about s. malt. but am quite good at reading the research on it because of my research background. So I actually don't think I can answer a lot of questions about it just help you interpert what I've read.

 

[etabetac]

Just wanted to say that I don't know that much about s. malt. but am quite good at reading the research on it because of my research background. So I actually don't think I can answer a lot of questions about it just help you interpert what I've read.

 

[Sevenstars]

I also frequently culture S. Maltophilia. Like others have suggested, you should ask her doctor about synergy testing. One drug may not kill it in the normal screenings, but a combo might do the trick.

To directly answer your question: Yes, tune ups do help for resistant bugs... usually. It's not all about the IV antibitoics, though they certainly play a large part. Being in the hospital, resting, getting more treatments per day... all contribute to a successful tune up.

Also, be vigilant in fighting this bug now, while it's "fresh." Her PFTs have not been down for long, so there probably isn't much permanent damage, if any. If she can kick it now, she can get her PFTs back up to that 100%+, but if you wait too long to be aggressive, it might be much harder or impossible. (take this with a grain of salt, this is just going off my personal experience)

Best of luck.

 

[Sevenstars]

I also frequently culture S. Maltophilia. Like others have suggested, you should ask her doctor about synergy testing. One drug may not kill it in the normal screenings, but a combo might do the trick.

To directly answer your question: Yes, tune ups do help for resistant bugs... usually. It's not all about the IV antibitoics, though they certainly play a large part. Being in the hospital, resting, getting more treatments per day... all contribute to a successful tune up.

Also, be vigilant in fighting this bug now, while it's "fresh." Her PFTs have not been down for long, so there probably isn't much permanent damage, if any. If she can kick it now, she can get her PFTs back up to that 100%+, but if you wait too long to be aggressive, it might be much harder or impossible. (take this with a grain of salt, this is just going off my personal experience)

Best of luck.

 

[Sevenstars]

I also frequently culture S. Maltophilia. Like others have suggested, you should ask her doctor about synergy testing. One drug may not kill it in the normal screenings, but a combo might do the trick.

To directly answer your question: Yes, tune ups do help for resistant bugs... usually. It's not all about the IV antibitoics, though they certainly play a large part. Being in the hospital, resting, getting more treatments per day... all contribute to a successful tune up.

Also, be vigilant in fighting this bug now, while it's "fresh." Her PFTs have not been down for long, so there probably isn't much permanent damage, if any. If she can kick it now, she can get her PFTs back up to that 100%+, but if you wait too long to be aggressive, it might be much harder or impossible. (take this with a grain of salt, this is just going off my personal experience)

Best of luck.

 

[Sevenstars]

I also frequently culture S. Maltophilia. Like others have suggested, you should ask her doctor about synergy testing. One drug may not kill it in the normal screenings, but a combo might do the trick.

To directly answer your question: Yes, tune ups do help for resistant bugs... usually. It's not all about the IV antibitoics, though they certainly play a large part. Being in the hospital, resting, getting more treatments per day... all contribute to a successful tune up.

Also, be vigilant in fighting this bug now, while it's "fresh." Her PFTs have not been down for long, so there probably isn't much permanent damage, if any. If she can kick it now, she can get her PFTs back up to that 100%+, but if you wait too long to be aggressive, it might be much harder or impossible. (take this with a grain of salt, this is just going off my personal experience)

Best of luck.

 

[Sevenstars]

I also frequently culture S. Maltophilia. Like others have suggested, you should ask her doctor about synergy testing. One drug may not kill it in the normal screenings, but a combo might do the trick.
<br />
<br />To directly answer your question: Yes, tune ups do help for resistant bugs... usually. It's not all about the IV antibitoics, though they certainly play a large part. Being in the hospital, resting, getting more treatments per day... all contribute to a successful tune up.
<br />
<br />Also, be vigilant in fighting this bug now, while it's "fresh." Her PFTs have not been down for long, so there probably isn't much permanent damage, if any. If she can kick it now, she can get her PFTs back up to that 100%+, but if you wait too long to be aggressive, it might be much harder or impossible. (take this with a grain of salt, this is just going off my personal experience)
<br />
<br />Best of luck.

 

[ToriMom]

Thank you all for your help/support. On the families side I only had one reply so I am pretty sure Sten Malt is more prevalent for adults so I appreciate your input. To answer some of the questions...Yes, it was a good sputum culture, and had substantial mucous to test. Yes, she takes Pulmozyme and does the vest, although the vest is new to us and maybe this is something we need to look at. Maybe she needs some manual CPT sessions with me again. Tomorrow I will know more about what they tested in the lab so far so I can ask about further synergy testing and also about getting more people to look at her case. After your replies I also think it would be wise to ask the adult CF doctor to consult with my Peds guy.

Thanks so much!!!!!
Michelle, mom to Tori, 7 w/CF and G-tube

 

[ToriMom]

Thank you all for your help/support. On the families side I only had one reply so I am pretty sure Sten Malt is more prevalent for adults so I appreciate your input. To answer some of the questions...Yes, it was a good sputum culture, and had substantial mucous to test. Yes, she takes Pulmozyme and does the vest, although the vest is new to us and maybe this is something we need to look at. Maybe she needs some manual CPT sessions with me again. Tomorrow I will know more about what they tested in the lab so far so I can ask about further synergy testing and also about getting more people to look at her case. After your replies I also think it would be wise to ask the adult CF doctor to consult with my Peds guy.

Thanks so much!!!!!
Michelle, mom to Tori, 7 w/CF and G-tube

 

[ToriMom]

Thank you all for your help/support. On the families side I only had one reply so I am pretty sure Sten Malt is more prevalent for adults so I appreciate your input. To answer some of the questions...Yes, it was a good sputum culture, and had substantial mucous to test. Yes, she takes Pulmozyme and does the vest, although the vest is new to us and maybe this is something we need to look at. Maybe she needs some manual CPT sessions with me again. Tomorrow I will know more about what they tested in the lab so far so I can ask about further synergy testing and also about getting more people to look at her case. After your replies I also think it would be wise to ask the adult CF doctor to consult with my Peds guy.

Thanks so much!!!!!
Michelle, mom to Tori, 7 w/CF and G-tube

 

[ToriMom]

Thank you all for your help/support. On the families side I only had one reply so I am pretty sure Sten Malt is more prevalent for adults so I appreciate your input. To answer some of the questions...Yes, it was a good sputum culture, and had substantial mucous to test. Yes, she takes Pulmozyme and does the vest, although the vest is new to us and maybe this is something we need to look at. Maybe she needs some manual CPT sessions with me again. Tomorrow I will know more about what they tested in the lab so far so I can ask about further synergy testing and also about getting more people to look at her case. After your replies I also think it would be wise to ask the adult CF doctor to consult with my Peds guy.

Thanks so much!!!!!
Michelle, mom to Tori, 7 w/CF and G-tube

 

[ToriMom]

Thank you all for your help/support. On the families side I only had one reply so I am pretty sure Sten Malt is more prevalent for adults so I appreciate your input. To answer some of the questions...Yes, it was a good sputum culture, and had substantial mucous to test. Yes, she takes Pulmozyme and does the vest, although the vest is new to us and maybe this is something we need to look at. Maybe she needs some manual CPT sessions with me again. Tomorrow I will know more about what they tested in the lab so far so I can ask about further synergy testing and also about getting more people to look at her case. After your replies I also think it would be wise to ask the adult CF doctor to consult with my Peds guy.
<br />
<br />Thanks so much!!!!!
<br />Michelle, mom to Tori, 7 w/CF and G-tube