Chronic Pseudomonas aeruginosa (Pa) | My Cayston Community™

CARLYE TOMCZYK

I think about Pa in two different ways: initial growth and chronic growth. CF throat or sputum cultures are the most common ways to confirm whether a person with CF has Pa in the lungs. Cultures are so important because sometimes you may be feeling just fine; however, the bacterium can still be found through a culture. We approach treatment for each of these situations differently.

Initial growth:

This is defined as the first time Pa shows up on your culture. With initial growth, we aim to eradicate—or completely get rid of—the Pa. As a pediatric provider, I encounter this type of situation most often. It is met with some degree of fear and feelings of “how did this happen?”

As a pediatric provider, I encounter this type of situation most often. It is met with some degree of fear and feelings of ‘how did this happen?’

Treatment:

Educating both patients and caregivers on the importance of following the treatment plan and providing the right support is critical for success. An aggressive treatment plan based on Cystic Fibrosis Foundation (CFF) Clinical Care Guidelines is prescribed, and usually, the entire multidisciplinary team is involved in making sure this plan can provide the best possible care. For example, the pharmacist ensures the prescription gets to the correct pharmacy, the social worker may help to find resources to assist with copays, and the respiratory therapist reviews the way to set up and use the new treatment with the patient. Along the way, the care team and I answer patient and caregiver questions to the best of our knowledge. During this time, we also talk about the possibility of chronic Pa, including the definition and the implications.

Chronic growth:

It is important to know that different CF providers and centers may have different definitions of “chronic growth.” While there is no gold standard to diagnose someone with chronic Pa, commonly used criteria define infection as chronic when more than 50% of the preceding 12 months’ cultures were positive for Pa.

Treatment:

You may find in talking with other CF patients and families that your treatment is different from theirs. This is because prescribed treatments can vary by age, severity of symptoms, and possible allergies.

Typically, inhaled antibiotics are used on a consistent basis. One treatment goal is to help reduce other respiratory symptoms, such as coughing, wheezing, and sputum production caused by chronic Pa. Additionally, treatment aims to help slow down significant progression of disease, including declining lung function.

Balancing the increased time requirement for nebulized medications with each patient’s lifestyle is important to treatment adherence. Partnership with patients, caregivers, and care center teams is critical for providing the best possible treatments for CF patients with Pa. Often, just talking to your care team about any trouble you may be experiencing fitting treatment into daily life can result in finding a solution to help complete treatment as prescribed.

Pa growth, whether initial or chronic, can be a challenging time for CF patients and their families. The internet has a lot of information about Pa, so be sure you are looking at trusted or well-known sites. Gathering as much information about Pa and associated treatment options as possible and then talking to your CF care team about this information will help you to feel more comfortable with the treatment plan and ultimate goals.

You can also read more about Pa here.