Mucoid Pseudomonas

hsnth2008

New member
Has anyone had experience with mucoid pseudomonas and been able to treat it? It seems like nothing is working- hospital stay for two weeks, Tobi, extra treatments...is there light at the end of the tunnel? Or is this a new base level?
 

LittleLab4CF

Super Moderator
It's a new baseline and time to enlist all the help you can for this fight. P.a. is extremely resistant to all antibiotics. Fluroquinolones are still effective to a degree and multiple antibiotic therapy using inhaled, IV and other delivery combinations have successfully eliminated substantial mucoid P.a. infections.

This topic comes up periodically and it sends me searching for the latest papers on the topic. My personal sense is the genetic genie is going to arrest CF in nearly all CFers, very soon. This leaves the resistant infections, tissue damage, diabetes and GI issues that still need solutions. Researchers haven't been idle and there's a lot of scientific papers that I suggest you Google or go to Google Scholar. The papers are not as dry and dull... In fact it is downright exciting. Topics include analysis of antibiotics for treating P.a.

From reading a great deal about an essentially incurable infection I have concluded those who have been cured of all P.a. infection were involved in some extreme medicine and novel thinking. Treating Multiple Drug Resistant (MDR) infections like P.a. is important for several reasons even if there's no getting rid of the infection. Antibiotics aimed at P.a. will kill some of the infection and hopefully keep it in check. Mucoid P.a. is cocooned in a slime produced when the P.a. turns on about 50 genes that produces extra alginate and transforms the bacteria so it can thrive in this new medium. Alginate or alginic acid and beta-lactamase are insoluble saccharides that a cooperative high density infection resides.

The barrier between the slime biofilm and living flesh is not an easy nut to crack. The good news is the huge increase in biofilm research often singles out CF patients with P.a. infections.

I believe that the only hope for fighting and eradicating P.a. do your own research. Don't buy an R&D lab, search for articles on P.a.. Most abstracts of scientific/medical papers are in plain language and the articles online often have links to unique terms.

Doctors haven't been as frustrated with patients coming in convinced they have something that they've read online since TV soap operas hit the airways. At the same time, CF is a rare and poorly understood disease and not every doctor is an expert in treating MDR infections we get. I don't believe in burying my doctor with information but to date every article I have handed a doctor was read on the spot. I have encountered a number of very promising therapies that have been written about in the last year.

Several unique and effective trials have been done in curing P.a. but my sense is the doctor is going after the infection as if it were an aggressive cancer. In other words brave doctors and brave patients are taking a certain cure or kill philosophy. Finding the best method may come down to finding the right doctor. Everything from nebulizing colloidal silver to xylotol is on the table and mucoid P.a. is tough enough for what I ordinarily wouldn't recommend to be considered.

Maintain as best you can, have hope and courage to find the best treatment.

LL
 

Kristan

New member
LittleLab - I have not been able to find a recipe for a xylitol solution for nebulizing. Have you come across a ratio? I have found that xylitol was a game changer for my sinuses and would like to try it for mucoid pseudomonas in my lungs.

hsnth - I have been using Cayston and most recently have started to add essential oils in the mix. I think nebulizing xylitol would help break up the biofilms and make the nebulized antibiotics more effective. There is a lot of encouraging research and you might want to read Chris's blog about drug development...unfortunately it seems to be a couple years out, but very hopeful info.
 

LittleLab4CF

Super Moderator
Kristan, A 5% xylitol solution has been established as safe for healthy lungs (1). My final remark from my previous post "Everything from nebulizing colloidal silver to xylitol is on the table and mucoid P.a. is tough enough for what I ordinarily wouldn't recommend to be considered." wasn't a wholesale recommendation to try the most extreme therapies. All that conventional medicine has to offer is the eradication of mucoid P.a. might work. When convention fails us, only the unconventional remains.

Several months back biofilms and mucoid v non mucoid P.a. were topic posts that raised the question of xylitol and mannitol for breaking down the saccharide based alginate slime produced by mucoid forms of pathogens like P.a. I know biofilms from another area of research, bio-scaffolding. We were using saccharides micro-printed in 3D to duplicate the protein scaffolding made to form the shape and function of every living structure in animals.

A reliable adage in chemistry is “like dissolves like” meaning a light oil or organic solvent will dissolve organic grease. In this case xylitol hydrates the slime increasing its permeability and making it flow for thorough expectoration. Our thick unmoving mucus is a kind of biofilm and probably the reason our P.a. infections turn mucoid. A person with normal mucus and healthy ducts and cilia won’t easily catch infections. As soon as you transform that mucus into a host medium, it’s a biofilm.

I have links to articles on nebulizing or inhaling xylitol and mannitol. My first reference describes a test using 5% xylitol. Generally in science and medicine a solution is percentage by weight. A 5% xylitol solution by weight: 100g of water to 5 grams of xylitol
.
A real world example to make about a cup (8floz) of 5% solution; Choose one of these equivalent values: 8 liquid ounces of water = 275 ml = 275 grams = 9.7 ounces by weight. And combine xylitol using one of these equivalent values: 5% of 275 grams = 12.5 grams = 0.45 ounces by weight and a volume unit is unreliable. Use tepid, boiled water and use a cup measure to obtain the required amount of water. Weigh a half ounce (0.45) of xylitol and dissolve it in the cup of water.

Xylitol is antimicrobial, a saccharide and an alcohol. Store your new medicine in a sterile bottle and keep it refrigerated. If this is for fighting an MDR infection like mucoid P.a. and you realize that you are working with thinly supported data, give it a try. Please keep me posted by PM on how it does. I am working on the efficacy of nebulized xylitol and other promising inhaled agents that will break down alginate slime.

I am not up to human trials by a long way. If I hadn’t run across several articles that tested and examined the effects of inhaled xylitol, I would have discouraged you or anybody from such bold and untested ground.

Check the links: (1) http://www.biomedcentral.com/content/pdf/1465-9921-5-13.pdf
http://www.biomedcentral.com/1741-7015/10/88/figure/F1

Proceed with caution, I believe there's real help in this,

LL
 

LittleLab4CF

Super Moderator
Absolutely, Bronchitol powdered inhalant works as well as xylitol, potentially. I haven't seen a commercial formulation of xylitol like Bronchitol that is in a powdered form. Like albuterol rescue inhalers that deliver a dry microcrystalline powder, finely powdered mannitol may have a delivery advantage. The end effect of mannitol and xylitol is more than a simple osmotic agent, which thins P.a. biofilms and our mucus.

Both xylitol and mannitol are sugar-alcohols, sweeter than sweet, these artificial sweeteners have the ability to hydrate mucoid biofilms like those made by P.a. and many MDR pathogens. And it thins our mucus, something that researchers have been struggling with for too long. Just by thinning our mucus and the mucoid slime from P.a. it becomes possible and even practical to expectorate whole infection colonies. A downside of mucoid P.a. is it lives in a cohesive blob that could be loosened and hocked up whole.

Osmotic agents are central to the conditions created by CF. Hydrating mucus or biofilms increases the porosity and therefore the permeability of the protective biofilm. This swollen goo attracts antibodies and white blood cells and this time they CAN break through the biofilm. Sugar-alcohols can lyse or explode microbes through swelling or uncontrollable uptake of water. It may sound like a panacea, a cure for all but mucoid P.a. is no longer in an asexual mode making more of identical bacteria. When mucoid bacteria swing, they sweat and absorb snippets of genetic material in a form of evolving reproduction. Mucoid bacteria is potentially adapting to any new therapy so the practice is multiple antibiotics and multiple delivery methods coupled with any agent that will weaken the biofilm castle walls.

Thanks for bringing up Bronchitol, when I was researching xylitol, powdered mannitol was the choice in several papers I read. I didn't realize Bronchitol or any powdered mannitol was available. Anybody who can obtain Bronchitol should give it a legitimate trial.

LL
 

Melissa75

Administrator
Thanks, LL, this is interesting information. Likewise, Jeanne, that blog post and the comments were enlightening.
 
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