pseudomonas aeruginosa 101

This is a compilation of my knowledge of Pseudomonas aeruginosa. There is a lot of misinformation and outdated research pertaining to Cystic Fibrosis on the internet so you must be careful what you read. If you would like to learn more about Cystic Fibrosis I suggest you visit the Cystic Fibrosis Foundation.

What is Pseudomonas aeruginosa?
Pseudomonas aeruginosa is a bacteria that colonizes in the thick mucus trapped in the airways and causes chronic respiratory infection in individuals with cystic fibrosis. Once it establishes itself in the respiratory tract it may be difficult to completely eradicate.

How is Pseudomonas aeruginosa treated?
Pseudomonas aeruginosa is treated using an inhaled form of the antibiotic tobramycin (TOBI) often in conjunction with oral Cipro. Chronic respiratory infections with this bacteria may also be treated with intravenous antibiotics. Nathan has not been treated intravenously yet so I will leave this topic, for now.

What is the eradication regimen using TOBI?
The recommendation is “28 days on, 28 days off” or every other month.

Why follow an eridication regimen?
Chronic respiratory infection with Pseudomonas aeruginosa is repsonsible for worse clinical statistics such as lower respiratory function (inflammation damages lung tissue), weight, height, and BMI (body mass index) in addition to more hospital admissions.

At what age did Nathan first culture positive for Pseudomonas aeruginosa?
Nathan was 5 months old.

Has Nathan been treated with oral Cipro?
Dr. A has discussed adding oral Cipro to his eradication regimen however up until this point Nathan has been exclusively on TOBI (February, May, and June).

Did Nathan culture positive for Pseudomonas aeruginosa during his July 1st clinic visit?
According to the sputum culture obtained at this visit, no Pseudmonas aeruginosa!!!!!! This does not mean it will not return but this is wonderful news, for now. He did culture positive for Staphylococcus aureus again but Dr. A will not be treating this bacteria yet.

Why not treat the Staphylococcus aureus?
Dr. A treated the Staphylococcus aureus last time with oral Bactrim because Nathan was visibly ill, vomiting, coughing, etc. Since his lungs sounded healthy at his clinic visit and he appears healthy, he will remain untreated for now.

Synergy between Staphylococcus aureus and Pseudomonas aeruginosa?
There have been studies that have concluded the presence of Staphylococcus aureus decreases the rate of infection by Pseudomonas aeruginosa. Nathan’s pediatric nurse K also explained this to me on the phone yesterday.

The new treatment plan?
I get Nathan gets the month of July without TOBI. Dr. A recommended that we begin the “28 days on, 28 days off” TOBI schedule in August.

For now, we remain out of the hospital, praise God!