resistant strep

[harmony]

I didn't know that labs can test for bacterial sensitivities to different types of antibiotics until last week. My sons (age 6) ENT did a culture from the mucus in my son's nose. It came back with heavy growth of Group A strep. The lab also tested the strep against 5 different types of antibiotics to test it's sensitivity level.

 

Does anyone know how accurate this testing is?

 

I am kind of worried-

Because they gave him a prescription for ammoxicillin (minimum 60 days) because that is what his strand showed sensitive to- is this enough?

 

4 month health History

Since school started he has had 3 strep throat infections (one was group B ), 4 sinus infections (only cultured 1, +strep A) and regular colds and stomach bugs. It seems as though the antibiotics make him well- but only for a few days- week at a time before he gets sick again. (all this time- has been a neurological roller coaster for him).

 

From mid Nov- Dec.

he was put on Clyndamicin (10 days) to fight group B in throat and minor sinus infection from his Ped. It seemed like he was better until 3 days after completion of antibiotics- so we went to immunologist- she gave him Biaxin for major sinus infection (21 day script- only completed 10+- days because it made he VERY sick- Dr. told us to stop meds immediately). He did great for around 7 days after antibiotic until he developed sudden fever and sudden congestion (very odd). This happened on Friday- we waited til Monday- took him into ENT.

 

Monday (JAN 11) - ENT packed his nose w/steroids, vacuumed nose, sent off culture (heavy growth group A) and ordered another CT (last sinus CT- 6 weeks prior- looked pretty good).

Tuesday- in ER. Fever 103, so congested couldn't breath at all out of nose, major headache, right eye swelling with drainage, heart rate in 160s and mucus draining from butt. CT reveals no brain or eye damage- infection contained in nose.

Wednesday- got another CT- this one 3D- to help with surgery.

Thursday- Surgery 6AM. 3 + hours. Cut turbines, septum, ethmoid bone and drained all sinuses and removed polyps and scar tissue (from previous sinus surgery 3 years ago) and removed tonsils.

 

2 weeks of recovery

 

next surgery tomorrow to remove any debris and drain sinuses again.

[harmony]

I forgot to put - that he has had negative throat cultures in between positive Strep throat.

[peglem]

I think I read somewhere that finding what kills bacteria in a petri dish is not the same as how it works in the body...

 

But, the question that comes to my mind is why isn't his immune system able to fight off these infections? Had immune testing done?

[harmony]

I think I read somewhere that finding what kills bacteria in a petri dish is not the same as how it works in the body...

 

But, the question that comes to my mind is why isn't his immune system able to fight off these infections? Had immune testing done?

Yep, he has had immunological blood work done by Infectious Disease and Immunology. Everything shows negative except H. Pylori and Epstein Barr (and from what I understand- both are common and would not be cause).

 

Is there a particular test you recommend he get done?

I will post what types of test he has had done, just give me a minute....

Thank you

[peglem]

I think I read somewhere that finding what kills bacteria in a petri dish is not the same as how it works in the body...

 

But, the question that comes to my mind is why isn't his immune system able to fight off these infections? Had immune testing done?

Yep, he has had immunological blood work done by Infectious Disease and Immunology. Everything shows negative except H. Pylori and Epstein Barr (and from what I understand- both are common and would not be cause).

 

Is there a particular test you recommend he get done?

I will post what types of test he has had done, just give me a minute....

Thank you

Oh, i was thinking about testing IgG levels + IgG subclasses, IgA, IgM...that sort of thing, not so much titers to specific pathogens.

[harmony]

Oh, i was thinking about testing IgG levels + IgG subclasses, IgA, IgM...that sort of thing, not so much titers to specific pathogens.

 

 

Here is a list of what he has had done:

 

Please let me know specific test that you recommend- I do not understand ANY of this blood work "stuff".

 

 

White Blood count

Red Blood count

Hemoglobin

Hematocrit

MCV

MCH

MCHC

RDW

Platelet count

Absolute neutrophils

" " lymphocytes

" " monocytes

" " eosinophils

" " basophils

neutrophils

monocytes

eosinophils

basophils

Tissue Transglutaminase antibody IGG and IGA

Gliadin Antibody IGG and IGA

Anachoice screen

Immunoglobulin A M G

" " subclass G (1-4)

Immunoglobulin E

T4, free

TSH (3rd gereration)

Vitamin B12/Folate

Strep Pneumonia IGG AB (14 subclasses)

Thyroid Peridase and Thyroglobulin antibodies

Protein total and protein electrophoresis

H. Pylori

[peglem]

Immunoglobulin A M G

" " subclass G (1-4)

Immunoglobulin E

 

Those are the ones I was talking about. It looks like the doctors are on top of it. Did you get test results yet? What do the doctors say about the results?

[Caryn]

I read the laundry list of tests you had done. Just curious if your son's IgA levels are low?

 

That is common for kids to test negative to autoimmune disease when they have low IgA levels as their bodies do not produce enough antibodies to test positive even though the disease is present.

 

This is particularly true in pediatric cases of Celiac.

 

http://americanceliac.org/celiac-disease/diagnosis/

 

There is an underlying reason why your son cannot get well and stay well. Maybe you could ask about IgA levels. Also, you could look at the bilirubin and the creatinine levels. They measure liver and kidney function. My son is not dxd Pandas although we did originally think it was. He is a diagnosed Celiac. Was always very sick and in need of antibiotics, etc..... We have been on a new diet since 2007 and he doesn't have any symptoms of OCD, tics, and is no longer getting chronic infections. We also eat only organic, grass fed, we are on an antifungal, no artificial diet and we avoid corn.

 

Our son's creatinine levels were very high in his original CBC. He did not present with high strep antibodies but did get croup and severe ear and sinus infections. He also had digestive problems as well. Keep digging.

[thereishope]

I understand why you'd be nervous. When they do the surgery, do they put any type of antibiotic in the area they were working on?

 

So they went from strong meds to amoxicillan?

[harmony]

I understand why you'd be nervous. When they do the surgery, do they put any type of antibiotic in the area they were working on?

 

So they went from strong meds to amoxicillan?

Clyndamicin- Pediatrician

Biaxin- immunologist

Amoxicillan - ENT

It is the ENT that we have been working with in the last 2 weeks- since he is the specialist that did/is doing the surgeries. Nice guy- but doesn't listen well. Even though he knows the history- he is still insisting on amox.

 

They did not use topical antibiotic, that I know of. He had 2 rounds of IV antibiotic and IV steroids. (one of each in ER and during surgery). The ENT is convinced that the amoxicillan will be effective in eradicating the strep. I have already asked if he could take a sample from the next surgery tomorrow and retest. He said it was unnecessary since the lab work showed sensitivity to amox. I am going to beg tomorrow- I don't see how it could hurt to do a retest.

I wish that I knew more about sensitivity testing at the lab. I would feel much better if I knew it was accurate.

[harmony]

Immunoglobulin A M G

" " subclass G (1-4)

Immunoglobulin E

 

Those are the ones I was talking about. It looks like the doctors are on top of it. Did you get test results yet? What do the doctors say about the results?

Everything came back normal- these test were done in May 09.

Chronic infections have been a problem during the school year for the past 4 years. He has not had recent blood work done though- The Dr.s do not feel a repeat of test are necessary since they came back normal before- but they(ID and immunology) are having him retake a CF (cystic fibrosis sweat test) even though that came back normal.

 

I just don't know what to do - I am so tired of going to the Dr.s ALL time- for only short term fixes- I want my son to be able to have a normal / healthy life (Keep in mind- he has an exacerbation with viral and bacterial infections) !! He is such a good boy- and it breaks my heart when he cries and says "mom, I just want a good life" - between infections, constant Dr.s appointments (which he doesn't mind so much- he hates school), tics, anxiety and OCD- he has had a very tough time.

[peglem]

Well, they're missing something, somewhere...its extraordinary for your child to be going through all these infections and surgeries. Those labs last May were a snapshot of a little bitty part of his blood...I'd want them checked again, AND I'd want a copy of the actual lab results (from last May, too) so I could look at the #'s and seek out info. VERY frequently doctor's dismiss abnormal lab results because they don't think its "significant" and they'll tell you it came out normal. All these interventions and doctor's visits and they still don't know why your son is having problems? I think that's crazy!

[harmony]

Well, they're missing something, somewhere...its extraordinary for your child to be going through all these infections and surgeries. Those labs last May were a snapshot of a little bitty part of his blood...I'd want them checked again, AND I'd want a copy of the actual lab results (from last May, too) so I could look at the #'s and seek out info. VERY frequently doctor's dismiss abnormal lab results because they don't think its "significant" and they'll tell you it came out normal. All these interventions and doctor's visits and they still don't know why your son is having problems? I think that's crazy!

Oh ya- I have records of all apt.s and lab work from the last 2 years (it took me 2 years to realize that I should keep records). Thanks for your advice

[faith]

harmony,

I really feel for you, I've heard my kid say something like that too.......

 

Is your boy on longterm abx, or he just gets a round whenever he gets these sinus infections or other illness, sorry, can't tell from the post. Do they alleviate any of the neuro issues?

 

I havn't heard of the bacteria testing you described in the first post, why did they do that, under whose instructions? do they do that for everyone? it sounds interesting. does the doctor think it means anything that the strep was found in the mucious, but not in the throat? is that usual?

[thereishope]

Well, if it means anything, my son's strep throat did clear on amoxicillan. When he had his sinus infection, the amox didn't work and they went to Augmentin. That worked. Maybe you can strike a deal with him and ask for Augmentin. Being that amoxicillan is part of it. Ask him to do it for your own sanity. Maybe if you politely remind him that amox is part of it, he could be swayed?

 

 

I understand why you'd be nervous. When they do the surgery, do they put any type of antibiotic in the area they were working on?

 

So they went from strong meds to amoxicillan?

Clyndamicin- Pediatrician

Biaxin- immunologist

Amoxicillan - ENT

It is the ENT that we have been working with in the last 2 weeks- since he is the specialist that did/is doing the surgeries. Nice guy- but doesn't listen well. Even though he knows the history- he is still insisting on amox.

 

They did not use topical antibiotic, that I know of. He had 2 rounds of IV antibiotic and IV steroids. (one of each in ER and during surgery). The ENT is convinced that the amoxicillan will be effective in eradicating the strep. I have already asked if he could take a sample from the next surgery tomorrow and retest. He said it was unnecessary since the lab work showed sensitivity to amox. I am going to beg tomorrow- I don't see how it could hurt to do a retest.

I wish that I knew more about sensitivity testing at the lab. I would feel much better if I knew it was accurate.