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Any microbiologists/wound care specialists? Need help with pseudomonas please

(43 Posts)
Toughasoldboots Sat 08-Oct-11 21:47:23

I have had a rough summer, x3 laminectomies, ? Cauda equina.
Loss of function in r leg after prolapsed disc ( which my GP ignored for two years- for another time).

Got out of specialist London hospital as quickly as possible but now have hospital acquired infection in wound.

MRI shows not into spine yet but I am really panicking, I am being treated conservatively with co-amox .

I feel ill and know that this could turn into a big problem. Hospital would rather have me back in and seem very jumpy about it.

I have researched silver therapy and honey. I am desperate to avoid going back to hospital, it was filthy , nurses hygiene appalling ( I am registered nurse) and I just want to get a hold on this .

Really dry Saturday night topic but just on the chance that the right person reads this and could help- I would be very grateful

raindroprhyme Sun 09-Oct-11 10:07:27

Can you not ask GP to culture up wound infection and then they can treat aggrssively with apprpiate antibiotics?

Toughasoldboots Sun 09-Oct-11 10:26:44

It has been cultured- antibiotic resistant pseudomonas

jenniec79 Sun 09-Oct-11 10:42:26

Which antibiotics is it sensitive to though - sure there's something. You need your doctor to contact the micro lab who dealt with those samples - they may still be trying to find the right concoction for you. Home IVAbx might be an option once you know, too. Not worth trying to avoid hospital if you end up with the bugs reaching your spine though - you'll end up there for a whole lot longer! Is there another spinal unit reasonably close you could go to instead?

catsareevil Sun 09-Oct-11 10:46:29

If I had this and the hospital wanted me back in I would do that. I know what you mean about filthy hospitals though!

Is the pseudomaonas resisitant to co-amoc? If it is then why have they said that they are giving it? Would they give you a diferent antibiotic if you were readmited?

Squigglywiggly Sun 09-Oct-11 10:59:39

Co-amoxiclav is not normally used against pseudomonas. Would recommend speaking to hospital specialist / GP and getting them to speak to hospital microbiology specialists re culture results, local sensitivities and appropriate treatment.

toosoontoosoon Sun 09-Oct-11 11:06:11

Yikes, so sorry to hear this TAOB. You must be in some pain as well after all that, just what you don't need.

I don't know much about this but understand fully your reluctance to go back in there. Is there somewhere else local (private)? that could take you, or is that a no-no due to your having this thing?

I think you need to speak to your GP or consultant and state clearly that you don't wish to be readmitted, BUT you need this sorting right now, and what are they going to do about it.

It's all I can think of apart from turning up at your local A&E and making a fuss...they will want to deal with you fast if you let them know you have a HAI. It can bump you up queues and get you your own private room wink

I had a different one, GP was only real port of call till he put me on to the consultant to talk directly and we sorted it out between us, though it took a few months all in all. I'd say that's the way to go if you can.

Toughasoldboots Sun 09-Oct-11 11:15:25

That's what I thought squiggly- it is just a broad spectrum one. I have been back in and MRI and contrast MRI to see how deep it is and it is just on surface of wound so far. I also had cfs leak and there is a build up of fluid behind wound.

The hospital were excellent at the emergency stage but I don't understand what is going on now. In fact I thought that co-amox was cited as being a factor in creating environment for pseudo .

I am going to call microbiology tomorrow- I won't name hospital but it is specialist in spinal/Neuro in London ( quite obvious if anyone knows the field).

I have to go to GP tomorrow and thought I would ask for referral to wound care nurse at local burns/plastics hospital.

Thanks for all suggestions, I had excellent care from most of my team but the SHO is a lovely but bumbling man and I am wondering if this direction has come from him and not microbiology.

He did admit me last week without going through bed manager so I spent five hours in a wheelchair in corridor . My back was examined by some dirty lockers, no hand washing .

He then put a bit of hand gel on and went off into the ward. I can't face going back in there.

Thanks for all your responses- very appreciated.

ripstheirthroatoutliveupstairs Sun 09-Oct-11 11:19:57

If you still have an open wound have you looked at Betadine?
when I had MRSA, my wound was dressed with an iodine based dressing. It cleared up.
If a burns/plastics unit is an option, the hygiene should be better than an general surgical ward sadly.
Good luck.

toosoontoosoon Sun 09-Oct-11 11:20:11

Sounds diabolical...not even sure if hand gel works on this, it didn't work on what I had, you had to wash your hands with proper soap and water (or bleach grin)

I don't blame you and it sounds like you have a few avenues to follow up so I hope you get somewhere tomorrow with this.

(flight here btw) sending my love.

mosschops30 Sun 09-Oct-11 11:23:42

Can you speak to the infection control team at nearest major hospital? When i cobtracted MRSA they were the only people who knew what they were talking about, gave good consistent advice.
Tbh i found the consultant and my GP fairly useless.
Or the micro team, they will also know which antibiotics for which infectikns

Toughasoldboots Sun 09-Oct-11 11:35:09

Hello flight ( stop namechanging will you?!).
Thanks again to everyone for your wisdom and advice.
I think betadine sounds as if it can't do any harm- the wound was healed, but breaking down now.

I will call microbiologist at local and London hospital tomorrow and try and push for referral to queen vic in East Grinstead as I know they deal with this in burns a lot.

It is frightening that my wound was touched , it has confirmed pseudo in it and I hope the Dr didn't go straight to another patient.

I have never felt so low tbh, as if it's not enough to end up with permanent paralysis, I have got to try and stop this infection.

I don't have private health cover, but pretty sure that they wouldn't admit me with this. I think most are free from mrsa etc and won't admit people with anything like it .

mosschops30 Sun 09-Oct-11 11:44:26

I think people underestimate just how bad a wound infection can make you feel. I felt dirty, and it bought me even lower than i was already.
Private hosputals do take patients with infection, but they do screen everyone and are more careful (e.g. Infected patients go at the end of a theatre list so it can be deep cleaned)

Inadine is only useful in certain types of wound, and if you over use it it can delay the healing process.

Dont try anything until you have good advice from wound specialist nurse/ microbiology/infection control

Toughasoldboots Sun 09-Oct-11 12:00:04

Yes, mosschops- that is how I feel, dirty. I won't let anyone visit me and I am just isolating myself in one room upstairs with a dh who although works from home, forgets I am here most of the time.

I am more worried because I see how jumpy they are about it in London- sending an ambulance for me and doing midnight MRI scans .

If it gets into my spine, I have been told that there is high mortality rate - I have got to get a grip on myself and stop thinking the worst.

DaisySteiner Sun 09-Oct-11 12:17:11

Agree, you need specialist micro input. One of the features of Pseudomonas is that it is generally resistant to beta lactams, so it seems very odd that they are treating you with co-amox! There are a number of antibiotics that may be effective. Have they determined whether it is indeed sensitive to these? Yes, the SHO should have washed his hands but Pseudomonas should be killed by alcohol gel, so try not to worry too much on that account.

mosschops30 Sun 09-Oct-11 12:32:05

tough i am sending you lots of un-MN hugs smile
please try not to think the worst, although being a nurse too i know that we tend to think a headache is a brain tumour!
Worst case scenarios of evrything is usually fatal, but thankfully very rare

Toughasoldboots Sun 09-Oct-11 12:42:52

Ha- yes we do moss. Trouble is, I had got myself over that and then everything did go really wrong over the summer.
They do seem very concerned though and have left me their direct bleep numbers, so I should be grateful that they are taking it seriously.

I can see myself insisting that anyone who touches my back dips their hands in bleach first now.

toosoontoosoon Sun 09-Oct-11 16:55:58

let us know how you get on, duck. I'm sorry you are feeling rubbish...I know what it's like, I felt so horrid when I was ill, and avoided seeing people or having visitors. My family still visited and not one of them went away with it, so it wasn't that easy to share apparently smile

We will be around when you have more news and I hope it goes well tomorrow if you manage to get to see anyone xx

CMOTdibbler Sun 09-Oct-11 20:14:34

The Queen Vic is amazing, and obv they are brill at wound care. The trouble you might have is that they might be worried about their inability to monitor deeper as they don't have MRI or CT there

Toughasoldboots Sun 09-Oct-11 21:06:32

Ah- that is helpful, thank you. Quite surprised about that really. Thank you so much for all your help and advice on quite a boring subject.
I will let you know what GP says tomorrow.

mosschops30 Mon 10-Oct-11 19:03:17

How did you get on?

toosoontoosoon Mon 10-Oct-11 21:13:41

Hope she's alright and getting the right meds now.

Toughasoldboots Tue 11-Oct-11 10:35:40

Sorry, thanks for asking, I can't get appointment with GP as I have to call for same day appointment and by the time I get through all have gone. They won't let me pre-book. I have emailed complaint to surgery today as I am already two days behind now and was meant to have blood/swabs taken.

I have called pharmacy at hospital and microbiology and they won't deal with me directly.

I tried consultant secretary- no answer.

I tried SHO- in theatre all day.

I am throwing up constantly and feel half dead.
Don't know what to do .

toosoontoosoon Tue 11-Oct-11 10:40:31

A&E if you can sweetheart...is DH still there? You probably need to be admitted. Go to your nearest.

toosoontoosoon Tue 11-Oct-11 10:41:56

IN fact I would call an ambulance but then I do tend to panic a bit smile

please don't wait any longer, the sickness could be a CSF related symptom I think. I don't know. Don't want to make things worse.

I'm really concerned about you.

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