+ + Pseudomonas Aeruginosa superbug.

[Dave-G]

Are there any experts on here who can advise what the ++ part of Pseudomonas Aeruginosa superbug means?

I've Googled loads of information about the infection and its apparently last resort antibiotic treated: Ciprofloxacin but I'm not seeing reference to the ++ part that shows on its culture result. I suspect it refers to its 'strength' but that's supposition on my part.

I've had it for months, hoping it would clear itself but eventually had to seek treatment and the first 5 day 750mg twice daily treatment didn't clear it - in fact I think its failure to clear it strengthened it. It came back worse within two days.

I now have 14 days worth after a week of relapse trying to obtain more from a slowed down medical centre.

I've had COPD/emphysema for several years so all the antibiotics and steroids have screwed my autoimmunity up. I think my wife has it but she's in stubborn denial, she doesn't do PC/internet and only believes what she reads in the Sun or reluctantly on the news which she doesn't like watching. 

Our daughter works in a care home so is around a lot of old/sick people - but the wife is her taxi to and from work which is why I want to see if she is endangering our well being by doing that.

Edited February 13, 2023 by Dave-G

[GingerCat]

Google says 

Pseudomonas is contagious. Transmission is possible through contact with contaminated surfaces or equipment, and also the consumption of contaminated water or fruit and vegetables. It can also pass from person to person via contact with hands and skin.

[7daysinaweek]

Hi Dave

The ++ is the amount of bacterial growth of the bacteria from the cultured swab, urine or sputum sample.

+ low growth

++ Heavy growth

Ciprofloxacin is used as the bacteria is sensitive to this type of antibiotic.

 

Just to make you aware and have probably been told when you were prescribed the cipro which is a fluoroquinolone, this medicine carries a risk of developing tendinitis though rare. If you also take corticosteroids the risk is further increased as with age in the older adult. If a patient develops tendon pain, hot painful joint pain,chest pain or other signs and symptoms of concern the MHRA advice is to stop taking it and get seen immediatley. I prescribe cipro on a daily basis mostly for eye, ear, chest, urine, kidney and gonadal/sti infections infections and from the thousands of courses I can only bring to mind a handful of times when a patient has gone on to develop tendinitis.

I have put a link to the MHRA patient leaflet for fluroquinilones gives further information. Taken from the revised January 2022 clinical knowledge summary nhs pathways for clinicians and is current: 

Important safety information

Important safety informationFor all quinolones

https://assets.publishing.service.gov.uk/media/5c9364c6e5274a48edb9a9fa/FQ-patient-sheet-final.pdf

[Dave-G]

1 hour ago, 7daysinaweek said:

Hi Dave

The ++ is the amount of bacterial growth of the bacteria from the cultured swab, urine or sputum sample.

+ low growth

++ Heavy growth

Ciprofloxacin is used as the bacteria is sensitive to this type of antibiotic.

 

Just to make you aware and have probably been told when you were prescribed the cipro which is a fluoroquinolone, this medicine carries a risk of developing tendinitis though rare. If you also take corticosteroids the risk is further increased as with age in the older adult. If a patient develops tendon pain, hot painful joint pain,chest pain or other signs and symptoms of concern the MHRA advice is to stop taking it and get seen immediatley. I prescribe cipro on a daily basis mostly for eye, ear, chest, urine, kidney and gonadal/sti infections infections and from the thousands of courses I can only bring to mind a handful of times when a patient has gone on to develop tendinitis.

I have put a link to the MHRA patient leaflet for fluroquinilones gives further information. Taken from the revised January 2022 clinical knowledge summary nhs pathways for clinicians and is current: 

Important safety information

Important safety informationFor all quinolones

https://assets.publishing.service.gov.uk/media/5c9364c6e5274a48edb9a9fa/FQ-patient-sheet-final.pdf

Thanks so much for that.

The side effects thus far are the publicised very dry throat and mouth + I've also got the opposite of the possible diarrhea: very dry small pellets that barely move along which scares me because my diverticula is likely to result in another diverticulitis issue. 

Doctors appointments around here are typically 7 days ish - as are the email contact that are declared to be a 2 day turn around. 

I shall now follow the link you posted.           

Edited February 13, 2023 by Dave-G

[Jaymo]

12 hours ago, 7daysinaweek said:

 

Just to make you aware and have probably been told when you were prescribed the cipro which is a fluoroquinolone, this medicine carries a risk of developing tendinitis though rare. If you also take corticosteroids the risk is further increased as with age in the older adult. If a patient develops tendon pain, hot painful joint pain,chest pain or other signs and symptoms of concern the MHRA advice is to stop taking it and get seen immediatley. I prescribe cipro on a daily basis mostly for eye, ear, chest, urine, kidney and gonadal/sti infections infections and from the thousands of courses I can only bring to mind a handful of times when a patient has gone on to develop tendinitis.

I’m one I’m afraid. 
Do wish my GP had passed on the same info as the enclosed patient leaflet, had the usual ‘warnings’. 
Six years later and one elbow operation and I still have effects of taking them. 
 

[7daysinaweek]

20 hours ago, Dave-G said:

Thanks so much for that.

The side effects thus far are the publicised very dry throat and mouth + I've also got the opposite of the possible diarrhea: very dry small pellets that barely move along which scares me because my diverticula is likely to result in another diverticulitis issue. 

Doctors appointments around here are typically 7 days ish - as are the email contact that are declared to be a 2 day turn around. 

I shall now follow the link you posted.           

No problem Dave.

Hope you get sorted

atb

9 hours ago, Jaymo said:

I’m one I’m afraid. 
Do wish my GP had passed on the same info as the enclosed patient leaflet, had the usual ‘warnings’. 
Six years later and one elbow operation and I still have effects of taking them. 
 

That is very unfortunate Jaymo.

In the absense of a history of tendon/joint disorder and related risk factors there is no real way of estimating with great probability that one will go on to develop fluroquinolone associated inflammation. I do feel for you as the adverse effect is rare and it would appear that has left you with irreversible complications. In the handful of patients that I have known to develop it, I note that the pain was significant and quite incapacitating.

I will avoid prescribing them in almost all cases if there is a history of tendon disorders. When prescribed I 'red flag' the patient for concerning symptoms, when they should stop taking them and seek very timely review.

All classess of antibiotics carry risks, some more than others. Penicillin being the safest in all age groups. Fluroquinolones still are extremely useful though.

In relation to antibitics I would always make the the presciber aware, which I am sure you do that you have had a previous fluroquinolone associated tendinothopy and that it also resulted in chronic long term complications. I would assume it would be documented on your gp record and this would also reflect in your SCR record that most other secondary and primary nhs care services will have access to if required (out of hours gp services , aed etc)

atb

 

[Jaymo]

15 hours ago, 7daysinaweek said:

No problem Dave.

Hope you get sorted

atb

That is very unfortunate Jaymo.

In the absense of a history of tendon/joint disorder and related risk factors there is no real way of estimating with great probability that one will go on to develop fluroquinolone associated inflammation. I do feel for you as the adverse effect is rare and it would appear that has left you with irreversible complications. In the handful of patients that I have known to develop it, I note that the pain was significant and quite incapacitating.

I will avoid prescribing them in almost all cases if there is a history of tendon disorders. When prescribed I 'red flag' the patient for concerning symptoms, when they should stop taking them and seek very timely review.

All classess of antibiotics carry risks, some more than others. Penicillin being the safest in all age groups. Fluroquinolones still are extremely useful though.

In relation to antibitics I would always make the the presciber aware, which I am sure you do that you have had a previous fluroquinolone associated tendinothopy and that it also resulted in chronic long term complications. I would assume it would be documented on your gp record and this would also reflect in your SCR record that most other secondary and primary nhs care services will have access to if required (out of hours gp services , aed etc)

atb

 

Stubborn prostatitis that had reoccurred ( once again) was the reason for their issue.
Cleared it up a treat, but obviously I will not be repeating that route. Subsequent antibiotics such as doxycycline don’t have the desired effect unfortunately. 
 

When I was prescribed them originally I made the mistake of carrying two large ammo boxes containing 500 12g in each. 
My arms locked and felt like they were in springs in the curled position. 
This eventually subsided and I stopped the tablets immediately. 
 

The tennis elbow and subsequent op highlighted the poor state of of the tendons in that area. 
That was a few years ago, but last year I stupidly took part in a parents sprint race at our boys sports day ( wasn’t going to let the younger days get the better of this fat old boy) 
Was running bare foot on slippery grass and since that day, both Achilles have been uncomfortable. 
Oh well, am hopeful of some respite with time. 

 

[discobob]

@jaymo - I done something similar about 10 years ago when the kids had stunt scooters and I took them to a local skate park - they wouldn't do something so to show them how to do it I had a go - I haven't lived that down to this day - I was limping for quite a while😁

There comes a time when you have to start acting your age and not your shoe size - I do understand yours was somewhat compounded by the medication... 

[7daysinaweek]

7 hours ago, Jaymo said:

Stubborn prostatitis that had reoccurred ( once again) was the reason for their issue.
Cleared it up a treat, but obviously I will not be repeating that route. Subsequent antibiotics such as doxycycline don’t have the desired effect unfortunately. 
 

When I was prescribed them originally I made the mistake of carrying two large ammo boxes containing 500 12g in each. 
My arms locked and felt like they were in springs in the curled position. 
This eventually subsided and I stopped the tablets immediately. 
 

The tennis elbow and subsequent op highlighted the poor state of of the tendons in that area. 
That was a few years ago, but last year I stupidly took part in a parents sprint race at our boys sports day ( wasn’t going to let the younger days get the better of this fat old boy) 
Was running bare foot on slippery grass and since that day, both Achilles have been uncomfortable. 
Oh well, am hopeful of some respite with time. 

 

Fluroqinolones are the medication of choice for treating prostatitis and it usually does the job as you found. I am told they taste bloody awful!

Trimethoprim and doxycycline are also useful for treatment failure and recurrent infection, a few others can aso be initiated but only under specialist advice. I like doxycycline, it is super useful for lots of different infections, downside to it is the nausea and get a fair few coming back because they cannot stomach it. 🤢

 

That sounded painful.

LOL 

The things we do to make our children 'proud'. Not so many years in the past, I jumped off a shed in the garden onto the large trampoline that we had. My son and his mate were doing the 'parkour' thing and I wanted to show them how it was meant to be done. Anyway after take off from the shed roof, I was quickly ejected into a crumpled mess on the ground. That was my trampolining days over, my left shoulder has never been the same.

Hopefully with time your achilles improves, time scales for damage and ruptures can take from  3-6-12-24 months. Some people find sports physio achilles exercises beneficial for both short and long term achilles tendinothopy, however it is not always easy to find the time in a busy scedhule. 

Ahh the joys of aging that I also feel nearing my mid fifties.

Keep taking the tablets and a dram! 

atb

 

[Dave-G]

26 minutes ago, 7daysinaweek said:

I like doxycycline, it is super useful for lots of different infections, downside to it is the nausea and get a fair few coming back because they cannot stomach it. 🤢

 

Doxycycline and Prednisilone are my COPD rescue pack standby in reserve. Regarding the nausea:

Google produces a result that Doxycycline should be taken alone.... there's a learning curve for anyone who always believes the first few google results.

[7daysinaweek]

29 minutes ago, Dave-G said:

Doxycycline and Prednisilone are my COPD rescue pack standby in reserve. Regarding the nausea:

Google produces a result that Doxycycline should be taken alone.... there's a learning curve for anyone who always believes the first few google results.

🤢 For sure.

Take with food or milk well before beddy-byes to reduce induced nausea and reflux. 

Here's to wishing you well Dave and hopefully not needing use of your pack for the better improving months to come.

atb

[Dave-G]

1 hour ago, 7daysinaweek said:

🤢 For sure.

Take with food or milk well before beddy-byes to reduce induced nausea and reflux. 

Here's to wishing you well Dave and hopefully not needing use of your pack for the better improving months to come.

atb

Bless.

[Penelope]

14 hours ago, 7daysinaweek said:

Ahh the joys of aging that I also feel nearing my mid fifties.

Amen, brother!!