bacterial infections

saywhatyouwill · #1 03-06-2009, 11:34 AM

when your little uns are on antibiotics for these, do you hand in a secretion sample as a matter of course?
who do you hand the samples in to; how long do they take to come back?

Wooders80 · #2 03-06-2009, 12:43 PM

Generally give a sample in first to see if we need antibiotics in the first place, unless Dominic is really ill. If Dominic has incresed secretions/ thicker secretions I'll do a sample - virology and culture and sensitivity (bacteria). We either get the Community Nurse to do a sample/ hand one in at the GP/ take one to the local emergency admissions unit we have open access to. Each time we visit hospital I ask for a few specimen pots so that I can do a sample when I think we need to.

It takes 2-3 days for the results to come back. Our doctors then use these results to decide what antibiotics, if any, we need. We don't generally retest when we finish the course of antibiotics though.

Probably costing the NHS quite a lot in secretion samples here!

JWorthington · #3 03-06-2009, 01:51 PM

Like Laura, we have a drawer full of pots

If we are concerned I take a sample and drop it into the children's ward at our local hospital where sam has open access. Initial results for nasties like RSV are usually back in a few hours, but more detailed results take 2-3 days, they then usually check for sensitivities to see which antibiotic to prescribe.

Julie x

TommysDad · #4 03-06-2009, 03:42 PM

Our ENT/PULM is out of state. (We do have an in-state children's hospital we can go to for emergencies, but Tommy's infections have always been cured with antibiotics or time...Nothing a trip to our local children's hospital can fix without a trache culture first. So, we just deal with the out of state hospital as much as possable, but anyways...) Whenever we think Tommy's coming down with something, our ENT or Pulm order a trache-aspirate culture. We know how to do them ourselves, stay sterile, etc., and we have Allegiance's (a Cardinal Health Company) Mucous Speciment Traps at home to collect the secretion sample. (These are provided by our DME and Medicaid pays for 2 per month here.)

Once we know our local lab has gotten the faxed doctor's orders, we take the sample at home, and I go to drop it off at the lab. Our local lab is covered by our private insurance so we use them first for cost and location, location, location. Then the lab has to transport it to the laboratory and let it grow for 72 hours??? We have learned the very hard way our doctors have to specify 3 things on the prescription: 1.) "Gram Stain", 2.) "Respitory Culture" (our lab was testing it for strep throat & it kept coming back negative. Yet we knew Tommy had a "respitory" infection!!! We later found out our lab wasn't doing a "respitory culture" DUH!) and 3.) "ID Insensitivity". In the children's hospital, this all seems to be a given with a trache culture, but I guess our out-of-the-hospital/non-children's hospital lab just doesn't get that many trache cultures. So, they don't know what to do without specific orders. (Oh! Also, if we want that trache culture tested for MRSA in the trache, we now found out we have to specify that as well. Makes me wonder what we are not finding at our local lab because we didn't know we had to specifically ask for them to test for it!

)

If Tommy's really sick and I don't think he can wait to start treatment in 3 more days, I usually call the ENT/Pulm in a day or two just to see if they see something growing, but even if they see something growing, many times they will still say they have to wait for the "sensitivities" to come back to know what drug & strength they need to prescribe. However, there have been times they will tell us to take the trache culture first and start antibiotics right away just incase (especially since we are 500 miles away from them and Tommy is on a vent).

I hear some pediatricians do all the work for the families, but ours 1.) doesn't have the kits, and 2.) she still tells us to take the sample

So, we have found it is just easier if we do it all at home & deal with the specialists over the phone and across state lines!

Sorry for the long response

~Maggie

twintotwin · #5 03-07-2009, 11:08 AM

We get the canisters ahead of time, then bring them to the lab & instruct them to send results to the pedi, pulm and/or ENT.

drct1245 · #6 03-07-2009, 02:41 PM

We too had canisters on hand so that we could just call the Dr to fax the orders and then drop it off. B/c they have to grow the bacteria, it takes a good week to know exactly what it is. Unless there was cause for concern, we never brought Ayden in to the ped or the pulm. They would just call in AB's if necessary. Ayden always grew certain cultures - it was just a matter of which grew heaviest and if he had symptoms, then we would treat.

saywhatyouwill · #7 03-08-2009, 03:27 AM

thanks

we don't, which is why i was asking. by the time we think she might have an infection we generally don't want to wait several more days before we start treating...it is probably wrong of us but giving samples to the GP is such a pain (they don't seem good at knowing what to do, or getting the results back) that we don't do it. maybe we should from now on. her respiratory dr said he thought it was okay to go straight to ABs, but she's on them yet again.