Pseudomonas

Question

Dear expert team,
our 1-year-old daughter has recently Pseudomonas in her routine throat swab.
Therefore she receives an antibiotic treatment.
Is a colonization with Pseudomonas at the age of 1 year unuasually early? Do we have to adapt ourselves to a severe course of the lung disease, because she has so early Pseudomonas? Does the colonization change the prognosis, in case one cannot get rid of the Pseudomonas? And what happens, if one cannot get rid of it?
Many thanks for your help!

Answer

Hello,
it is totally correct that your 1-year-old daughter with PSA colonization is treated with an antibiotic drug, e.g. with ciprofloxacin 2% liquid and likely also inhales with colistin/ tobramycin if necessary also with aztreonam.
Colonization with Pseudomonas aeruginosa at the age of 1 year is unfortunately not unusual. In here, many factors play a role.
Armstrong in Australia has found out children with PSA colonization very early via a very early bronchial lavage in the first year of life.
CF babies have a healthy lung when they are born. Already after 1-2 months, this status does unfortunately change relatively quickly.
In case of occurrence of an early colonization with PSA one can never conclude that the prognosis might be bad. Probably, an eradication of PSA is possible due to thorough care and with the help of a preventive and protective treatment.
For the whole life time one will pay attention to a colonization with problematic germs and then always react accordingly. The prognosis depends on so many factors. However an early colonization with PSA cannot be made equal with a poor prognosis.
It is important in the first years of life to realize an anti-inflammatory treatment and to pay attention to a good physiotherapy and to an effective inhalative therapy. A colonization with bacteria - it does not matter what the name of the germ is - should be avoided in my opinion.
In any case it is possible to get rid of the actual PSA colonization. There are enough possibilities. A colonization with PSA cannot be accepted in children under the age of 10. The CF center is always successful in eradication of this probelmatic germ.
Best regards,
Dr. H.-E. Heuer

29.09.2014