psuedenomas

[NancyR]

Hi my son is vent dependent and has psuedenomas(excuse the spelling. This is twice now. I would like to know if this is happening because of his humidifier. What is the best way to clean it and how often should it be cleaned? We have been taking it out every morning and cleaning with antibacterial soap and leaving upside down to dry before reusing. Could you give me any info on psuedenomas?
Thank You

[SCI-Nurse]

Pseudomonas is a common pathogen. It is a gram negative bug that lives normally in the bowel, but often causes both urinary tract and pulmonary infections. It likes warm, moist and dark areas. Generally if it actually causes infection the infection can be treated with antibiotics unless it is a drug-resistant strain. Did you doctor say that it was?

It is common to pass infections on through improperly cleaned ventilators. The tubing, Cascade, or other parts of the curcuit can harbor many types of bacteria.

In our area, chemical disinfectants are used in the home for cleaning any equipment that is not disposable. Is the soap and water routine what you were taught at the rehab center? I would contact them and ask what chemical disinfectant you can use and what is recommended. (KLD)

[Carl R]

I am a C5 motor C3 sensory quad. I am not on a vent, but still have a trach and have to suction 3 to 5 times daily. I was told I was colonized with pseudomonus and psoratious in my lungs. Different antibiotics help to control the bacteria and secretions, but we have not found a way to get rid of them. We clean all our trach supplies with vinegar and water.

Something else to ask your doctor about is a drug called pulmazyme(sp). After trying everything else for 6 months, we were finally able to dry up my secretions and get me off the vent. It is prescribed for kids with CF as a primary treatment, but might give you another alternative. Might also ask the doctor about theophyline as well.

[KLD]

Carl, I would suggest that you find something else to clean your suctioning equipment besides vinegar. In a study I was involved in years ago about cleaning urinary bags, we found that the bags cleaned with vinegar grew pseudomonas readily, in fact they LOVED vinegar!

Are you able to plug your trach between suctioning? If so, you may want to look into using an Olympic trach button instead of a regular trach. A regular trach tends to creat its own secreations by constant irritation of the trachea, and also harbors more bacteria that an Olympic. You can only use an Olympic if you are plugged all the time except for suctioning though (including night-time).

[Wise Young]

I agree with KLD. Pseudomonas have a reputation of being to grow under some of the most adverse conditions on earth. For example, there is a strain of pseudomonas that lives on jet fuel.

My wife, who is a microbiologist, says that chlorox is probably the best common substance for disinfecting surfaces. She pointed out that vinegar is actually made by bacteria (this is part of the fermentation process). Note that bacteria convert wine to vinegar and so bacteria can tolerate up to 3-5% ethanol levels as well.

Wise.

[NancyR]

Thank you all
Vinegar is exactly what we use for the urine bags. So I guess that will stop now. I assume then that bleach would be a better cleaning solution for the bags. My son doesn't suction at all for 2 yrs. now. We manually cough him and find that by eliminating suctioning he creates less secretions. The suctioning was just as irritate.

[Carl R]

thanks for the information on the vinegar. I will stop using it immediately. We have been cleaning all of my respiratory supplies with vinegar unfortunately.

The nursing agency that we use,Nursefinders, actually has written instructions in their procedure manual to use vinegar and water to clean all respiratory supplies. This is really disappointing to find out that my nurses may have been adding fuel to the fire, as far as my respiratory problems go. Is there a study that I can send them to show that vinegar could be dangerous?

This site is a lifesaver! Thanks for all the help.

[alan]

My urine culture this week showed 20,000 colonies of pseudomonas (don't know how I got it, since I don't cath.) I'm still running a low grade fever. My doctor says that if I don't stop running the fever, I'll have to go into the hospital for a couple of days to start IV antibiotics. :-(

[SCI-Nurse]

Alan, you are subject to pseudomonas infections if you have a SCI. Even if you don't cath, you are at increased risk if you use an external catheter or indwelling catheter. Several studies have shown that the penis gets colonized with bowel bacteria under externals, which create the perfect environment (warm, damp, dark) for these bugs to grow. If externals are not changed daily and good skin care done, the risk goes up. Having a high pressure bladder also increases the risk that bugs in the bladder will end up in the kidney by reflux, which is why you get symptoms such as fever, even with a relatively low bacterial count such as this. Usually it is not considered a UTI (even for ABs) without at least 100,000 bugs/cc.

With indwelling catheters the bugs actually crawl up the slime coating that develops on the inside walls of the catheter from the outside. Bowel bugs again are the most common ones to do this.

(KLD)

[alan]

Thanks, KLD. The fever seems to have gone away, so I guess I'm now just hosting a colony of unwanted parasites. There's always the option of going to the hospital for IV antibiotics, if the colonization gets worse and I get symptomatic again. :-(

I know central pain is a tough issue, but do you have any idea what I could take to control the CP-related queasiness that keeps me from going anywhere? I've tried things like phenergan, tigan, vistaril, others I've forgotten, coke syrup, and ginger ale with no relief. I'm trying to get an appointment at Mensana Clinic (well known pain clinic), so I've got to be able to get there.