Culture never growing out enough for susceptibilities??

[EmilysMomma]

So I have been having some sinus problems, major headaches , post nasal drip and has turned into congestion in my lungs too. I have been irrigating every day once with salt water than a little gentamycin rinse and the post nasal drip has calmed down and I can actually speak a full sentence without clearing my throat. The sinus headaches are still bad though, reaching for advil first thing in the morning. For about a month I've been having nastier sputum, it's darker and it tastes horrible, so I know something is growing down there.

I have done two sputum samples in a month the first came back staph aureus but non viable for susceptibility, I did have trouble coughing anything up that day so we figured there just wasn't enough. Did another and made sure it was first thing in the morning and was plenty in the cup. This one came back the same way showing it was staph aureus but non susceptible. The cf nurse coordinator that handles everything for me had the lab explain it to her that sometimes bacteria that's been cultured before doesn't grow out enough to show what would work on it. So then my Dr basically tells me he thinks its just my sinuses and just prescribes a month of augmentin which I figured wasn't going to do anything.

Well 2 1/2 weeks later I have no change at all except an awful yeast infection. So I called up for diflucan and said that I quit the augmentin and am still coughing up the nasty tasting sputum and I feel like it needs to be treated before it gets worse. I told her no I don't feel bad enough that I need iv abx (dont even have fever, only slightly feel achy if I don't take advil in the morning). I told her that the only oral abx that I remember ever doing anything when I culture staph is Zyvox (even though I've never cultured mrsa)or Doxy.

Has anyone else had a culture result like this? I've only been culturing staph on and off for about 4 years and it's always been MSSA. Also has anyone taken zyvox for regular staph, I have before and it worked but I was just curious if it should be more of a last resort.. Thanks in advance

 

[EmilysMomma]

So I have been having some sinus problems, major headaches , post nasal drip and has turned into congestion in my lungs too. I have been irrigating every day once with salt water than a little gentamycin rinse and the post nasal drip has calmed down and I can actually speak a full sentence without clearing my throat. The sinus headaches are still bad though, reaching for advil first thing in the morning. For about a month I've been having nastier sputum, it's darker and it tastes horrible, so I know something is growing down there.

I have done two sputum samples in a month the first came back staph aureus but non viable for susceptibility, I did have trouble coughing anything up that day so we figured there just wasn't enough. Did another and made sure it was first thing in the morning and was plenty in the cup. This one came back the same way showing it was staph aureus but non susceptible. The cf nurse coordinator that handles everything for me had the lab explain it to her that sometimes bacteria that's been cultured before doesn't grow out enough to show what would work on it. So then my Dr basically tells me he thinks its just my sinuses and just prescribes a month of augmentin which I figured wasn't going to do anything.

Well 2 1/2 weeks later I have no change at all except an awful yeast infection. So I called up for diflucan and said that I quit the augmentin and am still coughing up the nasty tasting sputum and I feel like it needs to be treated before it gets worse. I told her no I don't feel bad enough that I need iv abx (dont even have fever, only slightly feel achy if I don't take advil in the morning). I told her that the only oral abx that I remember ever doing anything when I culture staph is Zyvox (even though I've never cultured mrsa)or Doxy.

Has anyone else had a culture result like this? I've only been culturing staph on and off for about 4 years and it's always been MSSA. Also has anyone taken zyvox for regular staph, I have before and it worked but I was just curious if it should be more of a last resort.. Thanks in advance

 

[EmilysMomma]

So I have been having some sinus problems, major headaches , post nasal drip and has turned into congestion in my lungs too. I have been irrigating every day once with salt water than a little gentamycin rinse and the post nasal drip has calmed down and I can actually speak a full sentence without clearing my throat. The sinus headaches are still bad though, reaching for advil first thing in the morning. For about a month I've been having nastier sputum, it's darker and it tastes horrible, so I know something is growing down there.
<br />
<br />I have done two sputum samples in a month the first came back staph aureus but non viable for susceptibility, I did have trouble coughing anything up that day so we figured there just wasn't enough. Did another and made sure it was first thing in the morning and was plenty in the cup. This one came back the same way showing it was staph aureus but non susceptible. The cf nurse coordinator that handles everything for me had the lab explain it to her that sometimes bacteria that's been cultured before doesn't grow out enough to show what would work on it. So then my Dr basically tells me he thinks its just my sinuses and just prescribes a month of augmentin which I figured wasn't going to do anything.
<br />
<br /> Well 2 1/2 weeks later I have no change at all except an awful yeast infection. So I called up for diflucan and said that I quit the augmentin and am still coughing up the nasty tasting sputum and I feel like it needs to be treated before it gets worse. I told her no I don't feel bad enough that I need iv abx (dont even have fever, only slightly feel achy if I don't take advil in the morning). I told her that the only oral abx that I remember ever doing anything when I culture staph is Zyvox (even though I've never cultured mrsa)or Doxy.
<br />
<br />Has anyone else had a culture result like this? I've only been culturing staph on and off for about 4 years and it's always been MSSA. Also has anyone taken zyvox for regular staph, I have before and it worked but I was just curious if it should be more of a last resort.. Thanks in advance

 

[Jeana]

Try Septra DS. I often have cultures that they know are staph but don't grow out enough to see what it is.

 

[Jeana]

Try Septra DS. I often have cultures that they know are staph but don't grow out enough to see what it is.

 

[Jeana]

Try Septra DS. I often have cultures that they know are staph but don't grow out enough to see what it is.

 

[EmilysMomma]

Thanks for your input. Septra is the same as Bactrim right? I forgot to mention Bactrim hasn't worked for me in awhile, even when it has come up as susceptible. They are always trying to give me Cipro (doesn't do anything but give diarrhea) and Levaquin which I have tried twice before but didn't seem to do anything except make me nervous about ruptured tendons.

I wonder what it means when it doesn't grow out enough, seems so odd..

 

[EmilysMomma]

Thanks for your input. Septra is the same as Bactrim right? I forgot to mention Bactrim hasn't worked for me in awhile, even when it has come up as susceptible. They are always trying to give me Cipro (doesn't do anything but give diarrhea) and Levaquin which I have tried twice before but didn't seem to do anything except make me nervous about ruptured tendons.

I wonder what it means when it doesn't grow out enough, seems so odd..

 

[EmilysMomma]

Thanks for your input. Septra is the same as Bactrim right? I forgot to mention Bactrim hasn't worked for me in awhile, even when it has come up as susceptible. They are always trying to give me Cipro (doesn't do anything but give diarrhea) and Levaquin which I have tried twice before but didn't seem to do anything except make me nervous about ruptured tendons.
<br />
<br />I wonder what it means when it doesn't grow out enough, seems so odd..

 

[marcijo]

I culture regular staph and my "go to" med right now is doxy (I am allergic to sulfa/bactrim). I used to take keflex for everything but switched to doxy after a bad allergic reaction to augmentin. I hope you are feeling better soon!

 

[marcijo]

I culture regular staph and my "go to" med right now is doxy (I am allergic to sulfa/bactrim). I used to take keflex for everything but switched to doxy after a bad allergic reaction to augmentin. I hope you are feeling better soon!

 

[marcijo]

I culture regular staph and my "go to" med right now is doxy (I am allergic to sulfa/bactrim). I used to take keflex for everything but switched to doxy after a bad allergic reaction to augmentin. I hope you are feeling better soon!

 

[Jeana]

I was going to write more, but I had to leave suddenly. My doctor says mine are small colony variants. Here is a definition:

"The term "small colony variant" (SCV) refers to the phenomenon where certain variants of bacteria grow slowly on routine media and yield unexpectedly small colonies in comparison to the normally growing parent strains (for a review see reference 28). So far, nearly all SCVs isolated from clinical specimens have been identified as Staphylococcus aureus and were most commonly associated with persistent and relapsing infections."

from <a target=_blank class=ftalternatingbarlinklarge href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC105157/
">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC105157/
</a>
My doctor also says that they are so slow growing, that before we can tell what antibiotic to treat them with, they are gone. That seems to be the biggest problem with them. Sorry I was no help on the antibiotic. <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[Jeana]

I was going to write more, but I had to leave suddenly. My doctor says mine are small colony variants. Here is a definition:

"The term "small colony variant" (SCV) refers to the phenomenon where certain variants of bacteria grow slowly on routine media and yield unexpectedly small colonies in comparison to the normally growing parent strains (for a review see reference 28). So far, nearly all SCVs isolated from clinical specimens have been identified as Staphylococcus aureus and were most commonly associated with persistent and relapsing infections."

from <a target=_blank class=ftalternatingbarlinklarge href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC105157/
">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC105157/
</a>
My doctor also says that they are so slow growing, that before we can tell what antibiotic to treat them with, they are gone. That seems to be the biggest problem with them. Sorry I was no help on the antibiotic. <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[Jeana]

I was going to write more, but I had to leave suddenly. My doctor says mine are small colony variants. Here is a definition:
<br />
<br />"The term "small colony variant" (SCV) refers to the phenomenon where certain variants of bacteria grow slowly on routine media and yield unexpectedly small colonies in comparison to the normally growing parent strains (for a review see reference 28). So far, nearly all SCVs isolated from clinical specimens have been identified as Staphylococcus aureus and were most commonly associated with persistent and relapsing infections."
<br />
<br />from <a target=_blank class=ftalternatingbarlinklarge href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC105157/
">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC105157/
</a><br />
<br />My doctor also says that they are so slow growing, that before we can tell what antibiotic to treat them with, they are gone. That seems to be the biggest problem with them. Sorry I was no help on the antibiotic. <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[Jeana]

Okay, I was just doing some research and found this article extremely interesting.

<a target=_blank class=ftalternatingbarlinklarge href="http://path.upmc.edu/cases/case506/dx.html
">http://path.upmc.edu/cases/case506/dx.html
</a>
"The treatment of SCV S. aureus infection has not being defined yet. In a tissue-culture system with SCV inside the endothelial cells, SXT in combination with Rifampin was the most active therapeutic regimen, but many other antibiotics that penetrated well into mammalian cells were not effective against SCV S. aureus. Another treatment option would be reversal of auxotrophy, which is encouraging, because in vitro studies did result in making the organism more susceptible to antibiotics. For the menadione auxotrophs, <b>vitamin K administration </b>is able to do the reversal of auxotrophy (<b>clinical trials are to follow and see how beneficial it is</b>)."

Are you taking Vitamin K??

 

[Jeana]

Okay, I was just doing some research and found this article extremely interesting.

<a target=_blank class=ftalternatingbarlinklarge href="http://path.upmc.edu/cases/case506/dx.html
">http://path.upmc.edu/cases/case506/dx.html
</a>
"The treatment of SCV S. aureus infection has not being defined yet. In a tissue-culture system with SCV inside the endothelial cells, SXT in combination with Rifampin was the most active therapeutic regimen, but many other antibiotics that penetrated well into mammalian cells were not effective against SCV S. aureus. Another treatment option would be reversal of auxotrophy, which is encouraging, because in vitro studies did result in making the organism more susceptible to antibiotics. For the menadione auxotrophs, <b>vitamin K administration </b>is able to do the reversal of auxotrophy (<b>clinical trials are to follow and see how beneficial it is</b>)."

Are you taking Vitamin K??

 

[Jeana]

Okay, I was just doing some research and found this article extremely interesting.
<br />
<br /><a target=_blank class=ftalternatingbarlinklarge href="http://path.upmc.edu/cases/case506/dx.html
">http://path.upmc.edu/cases/case506/dx.html
</a><br />
<br />"The treatment of SCV S. aureus infection has not being defined yet. In a tissue-culture system with SCV inside the endothelial cells, SXT in combination with Rifampin was the most active therapeutic regimen, but many other antibiotics that penetrated well into mammalian cells were not effective against SCV S. aureus. Another treatment option would be reversal of auxotrophy, which is encouraging, because in vitro studies did result in making the organism more susceptible to antibiotics. For the menadione auxotrophs, <b>vitamin K administration </b>is able to do the reversal of auxotrophy (<b>clinical trials are to follow and see how beneficial it is</b>)."
<br />
<br />Are you taking Vitamin K??

 

[EmilysMomma]

That is very interesting, I really appreciate you taking the time to post all of that info!! It really sounds like what mine probably is because I never really have seemed to get rid of it completely even though I can go awhile with no problems. And it being caused by long term sxt therapy makes perfect sense because my Dr used to throw Bactrim at me everytime I had a problem, without even a culture, instead of just letting me get a piccline. This was while I was pregnant and for about 2 years after I delivered I was really sick and needed iv abx but my Dr just kept giving me Bactrim or Cipro. The only time I've gotten a bug free culture was for the months following iv abx I had 2 1/2 years ago.

I do take an abdek vitamin, currently Aquadeks but sometimes it's the Source Cf. Perhaps it wouldn't hurt to supplement with a little additional Vit K.

The Rifampin sounds interesting, it seems like it's usually for TB or mrsa but sounds like it possibly would really help with what I have. I have no idea how I would get my Dr to prescribe it though, I had to bug them a few times to get the Zyvox called in. If I didn't keep calling saying that coughing up gross tasting sputum isn't normal for me and I don't want to be doing that then he would have just let it go for now since there were no susceptibilities.

A lot of the things I mentioned above are reasons that I am looking into switching my care to an accredited cf center, my Dr has only 20-some patients, but that's all a whole different story that I made a post about a few weeks ago. I am going to bookmark that link you posted because I feel like it might come in handy, and I appreciate you sharing it with me.

The Zyvox has been called in but since it's so damn expensive I cant even pick itup until next Friday if I do decide to take it.

 

[EmilysMomma]

That is very interesting, I really appreciate you taking the time to post all of that info!! It really sounds like what mine probably is because I never really have seemed to get rid of it completely even though I can go awhile with no problems. And it being caused by long term sxt therapy makes perfect sense because my Dr used to throw Bactrim at me everytime I had a problem, without even a culture, instead of just letting me get a piccline. This was while I was pregnant and for about 2 years after I delivered I was really sick and needed iv abx but my Dr just kept giving me Bactrim or Cipro. The only time I've gotten a bug free culture was for the months following iv abx I had 2 1/2 years ago.

I do take an abdek vitamin, currently Aquadeks but sometimes it's the Source Cf. Perhaps it wouldn't hurt to supplement with a little additional Vit K.

The Rifampin sounds interesting, it seems like it's usually for TB or mrsa but sounds like it possibly would really help with what I have. I have no idea how I would get my Dr to prescribe it though, I had to bug them a few times to get the Zyvox called in. If I didn't keep calling saying that coughing up gross tasting sputum isn't normal for me and I don't want to be doing that then he would have just let it go for now since there were no susceptibilities.

A lot of the things I mentioned above are reasons that I am looking into switching my care to an accredited cf center, my Dr has only 20-some patients, but that's all a whole different story that I made a post about a few weeks ago. I am going to bookmark that link you posted because I feel like it might come in handy, and I appreciate you sharing it with me.

The Zyvox has been called in but since it's so damn expensive I cant even pick itup until next Friday if I do decide to take it.