Sputum sample tested positive for Pseudomonas aeruginosa

[Mustardfan]

I can see on the NHS App that my sputum sample tested positive for Pseudomonas aeruginosa. Does anyone know what treatment I might expect if I’m going to get good treatment? I was diagnosed with bronchiectasis last year. I had repeated chest infections over the recent winter (4 courses of antibiotics). I believe this is the first time my sputum has been tested for Pseudomonas - or is it always part of the standard test? If this is the first time, then I could have had it for a long time. I haven’t brought up any green sputum since May, when I last had antibiotics. My sputum turned green again about 2 weeks ago. There was a tiny bit of blood in it yesterday. My temperature is normal. SATS are 99. I’m dizzy at times (could be unrelated).

I’m asking on here as I don’t feel that I’ve been getting good care from the respiratory team or my GP practice. I would like to know what good care would look like. I saw a respiratory consultant in November, but not since then. The respiratory physio team have been fairly good and I do daily airway clearance. I have the worry that the doctor will say this doesn’t need to be treated as I’m not very unwell (apart from the dizziness, and a slight lack of energy). On the other hand I’m also very concerned about the high number on antibiotics I’ve taken. I could give a longer story about the bad care I’ve had, but this is already long.

Hi OP sorry you are going through this. When you say daily sputum clearance are you using a flutter valve if not it may be worth investing in one? Drinking plenty of water can also help. Have you been prescribed mucolytics such as carbocisteine? With regards to the positive sputum sample there will usually be an indication of which anti-biotics the bug is sensitive to / resistant to so you should be put on a course it is sensitive to. That said sometimes it can be colonization and our Consultants will only treat if symptomatic. We don't request a test for specific bugs but a broad test on any sputum we send in ( Microscopy, Culture, and Sensitivity). Hope that helps a bit.

Your sample would be sent for culture and sensitivity, rather than being ' tested ' for psuedonomas. If this is the first time psuedonomas has been isolated then I'd imagine the respiratory team would want to treat you aggressively - admit for two weeks or intravenous antibiotics. It might vary in your area but I'd contact the GP tomorrow and ask if they've spoken to the respiratory team for advice. It's not so much about you feeling unwell than that it's an significant pathogen if you have underlying bronchiectasis.

I'm sorry your care hasn't been good- that must be very frustrating.

Op please pm me regarding this. I’m a respiratory nurse in primary care and this is part of my job. Very very important to insist on treatment for this. You need to have some facts behind you to advocate for yourself

As someone has suggested above, it might be that it's been there before, but its now a pure growth rather than being mixed with another organism. Or that it's been in multiple samples before and they are now considering that it may be causing you problems if you are still unwell.

It's not part of your normal respiratory flora, so it shouldn't really he there. As someone has also said, they will culture for many different bacteria and see what grows, there will be a set protocol for what gets considered as being significant

Give the advice line at Asthma + Lung UK a call. It’s staffed by specialist nurses who can give you personalised advice and tell you what you should be getting and how to advocate for yourself. They were brilliant when DH was getting fobbed off by the respiratory team. Thanks to their advice he’s now getting biologics, after being poo-poohed for ages by the team here.

Thanks everyone. Yes, I’m using a flutter device and I’m taking carbocysteine.

If this is the first time psuedonomas has been isolated then I'd imagine the respiratory team would want to treat you aggressively - admit for two weeks or intravenous antibiotics.

In my area this is not correct. Firstly we offer an IV service at home and secondly would be looking at blood results prior to giving IV anti-biotics, we give oral as first line treatment if symptomatic. Admitting patients these days is a last resort if they cannot be treated in the community. Our hospital also offers a day unit where folk can go for IVs if not at home.

100% reach out tot he respiratory team, it is really disappointing that you have not felt supported by them. Wishes you luck for today.