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    SP Constant Clogging with proteus mirabilis

    I've had a supra pubic catheter for 4 years now and I would normally change it once a month but just within the last two months it clogs every 3-5 days with a white powdery sediment. I have always had sediment n a history of bladder stones but now it seems out of control all of a sudden.

    I've been to the uro n had a culture done. The doc found a bladder stone & my culture came back a < 100,000 cfu/ml proteus mirabilis. So he removed a stone n put me on antibiotics(kelphex or somthing like that). It worked till two days after the antibiotic was done. Then another clog. So I went back & he put me on 5 days two tablets of septra a day then 1/2 tab a day for a month.

    Does this seem ok? Also I've done ALOT of reading & I've heard alot of good things about Vetericyn. I was prescribed Renicide a while ago but never used it & it expired.. Is it similar, better, worse than Vetericyn? Has anyone overcome this uti? Sorry for rambling & Thanks ahead of time.

    PS this explains all the sediment n why my urine has an ammonia smell.
    http://en.wikipedia.org/wiki/Proteus_mirabilis
    Last edited by Padred123; 19 Jan 2012, 10:32 PM.
    C5/6 since Feb '07

    #2
    Are you sure that he got out all the stones...kidneys, ureters and bladder? Proteus is often associated with stones, and will cause the same infection to come back over and over as long as the stones remain, regardless of taking any antibotics.

    Have you tried daily routine Renacidin instillations through your catheter for the encrustations?

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

    Comment


      #3
      Originally posted by SCI-Nurse View Post
      Are you sure that he got out all the stones...kidneys, ureters and bladder? Proteus is often associated with stones, and will cause the same infection to come back over and over as long as the stones remain, regardless of taking any antibotics.

      Have you tried daily routine Renacidin instillations through your catheter for the encrustations?

      (KLD)
      The Dr ordered a xray that was negative of stones. I haven't used the renacidin yet. I was prescribed it a long time ago but never used it and now its out of date.

      What has better results Renacidin or Vetericyn? Anyone used both? Also I've read Proteus thrives in alkaline environments. Should I try to lower my ph(more acidic)? If so.. Any tips?
      C5/6 since Feb '07

      Comment


        #4
        I seem to be having a similar problem all of a sudden, without history of stones (so far ... that I know of). I have indwelling silicone 5 cc balloon catheters. But am seeing a lot of gunky/powdery buildup in the connector piece between the catheter and leg bag tubing.

        It seems that these clogs started coming after I cut way back on my alcohol consumption (from 3-4 times a week to 1-2 times a month). This issue may literally drive me to drink.

        I posted a question in this forum a couple days ago looking for what I thought were called 'super slick' indwelling Foley catheters (the only response I got suggested hydrophilic/lofric caths, but best I can tell they are only made for intermittent cathing). Also, I don't have UTI problems ever (maybe once a year at most).

        Comment


          #5
          Hi "Padred123,"
          Welcome to the Care Cure Community.

          How long were you on Keflex? You may not have been prescribed a long enough period of time for this drug for a neurogenic bladder. Typically, when I have had any antibiotics prescribed for urinary tract infections I have been directed to take them for 10-14 days, which is longer than usually prescribed for infections in the general population. In fact, I am wondering if your current prescription for Septra isn't setting you up for bacterial overgrowth.

          Renacidin and Vetericyn have different uses. Renacidin is used in the prevention and dissolution of calculi in the urinary tract. Vetericyn/Microcyn is a "proprietary formulation of oxy chlorine compounds based upon the Microcyn® Technology platform, Vetericyn Wound care is a one-step, pH-neutral and shelf-stable wound dressing that cleanses and debrides wounds, treats infections and speeds up the healing process." It is not an antibiotic. It does not treat calculi in the urinary tract. (See more at http://vetericyn.com/technology/faq.php)

          I have not used Renacidin and I cannot advise whether they can be used in combination. Personally, I have had excellent results in staying infection and colonization free for 20 months using Vetericyn bladder instillation. I have had a supra pubic catheter for just over 20 months. I am 29 years post injury and haven't had any calculi issues in that time (just not a stone/sediment maker, I guess). I would urge you to read and study all the threads and posts about Vetericyn to be able to make an informed decision about whether it is right for you. Here are a few of the most significant threads about Vetericyn.

          /forum/showthr...yn+open+letter
          /forum/showthr...wash+vetericyn
          /forum/showthr...wash+vetericyn
          /forum/showthr...ericyn+summary

          If you try an internet search "acidifying urine," you will find many articles with information about food, beverage, and supplement choices.

          All the best,
          GJ

          Comment


            #6
            Originally posted by gjnl View Post
            Hi "Padred123,"
            Welcome to the Care Cure Community.

            How long were you on Keflex? You may not have been prescribed a long enough period of time for this drug for a neurogenic bladder. Typically, when I have had any antibiotics prescribed for urinary tract infections I have been directed to take them for 10-14 days, which is longer than usually prescribed for infections in the general population. In fact, I am wondering if your current prescription for Septra isn't setting you up for bacterial overgrowth.

            Renacidin and Vetericyn have different uses. Renacidin is used in the prevention and dissolution of calculi in the urinary tract. Vetericyn/Microcyn is a "proprietary formulation of oxy chlorine compounds based upon the Microcyn® Technology platform, Vetericyn Wound care is a one-step, pH-neutral and shelf-stable wound dressing that cleanses and debrides wounds, treats infections and speeds up the healing process." It is not an antibiotic. It does not treat calculi in the urinary tract. (See more at http://vetericyn.com/technology/faq.php)

            I have not used Renacidin and I cannot advise whether they can be used in combination. Personally, I have had excellent results in staying infection and colonization free for 20 months using Vetericyn bladder instillation. I have had a supra pubic catheter for just over 20 months. I am 29 years post injury and haven't had any calculi issues in that time (just not a stone/sediment maker, I guess). I would urge you to read and study all the threads and posts about Vetericyn to be able to make an informed decision about whether it is right for you. Here are a few of the most significant threads about Vetericyn.

            https://www.carecure.net/forum/showthr...yn+open+letter
            https://www.carecure.net/forum/showthr...wash+vetericyn
            https://www.carecure.net/forum/showthr...wash+vetericyn
            https://www.carecure.net/forum/showthr...ericyn+summary

            If you try an internet search "acidifying urine," you will find many articles with information about food, beverage, and supplement choices.

            All the best,
            GJ
            Thanks for the info GJ! My Dr only had me on the Keflex for 5 days. I got off of it Dec 29. Then came New years eve.. I made the bad decision to drink Jack Daniels Honey two days in a row. My urine got dark and that night I had my first clog after finishing the Keflex.

            I changed my catheter and wrote it off to drinking liquor. I started drinking tons of water and 1 tbl spoon of cream of tarter a day. That really cleared my urine up but within 3 days I had another clog. I changed the catheter a couple more times after that. So I got sick of it and I went back to the Dr last Friday. Thats when he prescribed me the septra. I changed my cath again when I started the septra and got another clog on the 5th day of taking it.

            I flushed it out with distilled water really good which seemed to help. I also have been drinking tons of water and cream of tarter once a day. I'm feeling a little better now. I never used to flush my bladder but maybe it something that just needs done on a regular basis. I'm gonna try that and keep researching Renicidin Vs Vetericyn.

            As for PH I've been testing my urine and its been between 7 & 8. I'm gonna try to get it at least around 5 or 6 if I can. So it gives those bugs a harder time. My Dr gave me methenamine mandelate which may or may not help from what I've read. Also alot of vitamin C should lower the ph some. I found this website with alot of good info on urine PH. http://www.naturalhealthschool.com/pH-balance.html

            Originally posted by Quad Kings View Post
            I seem to be having a similar problem all of a sudden, without history of stones (so far ... that I know of). I have indwelling silicone 5 cc balloon catheters. But am seeing a lot of gunky/powdery buildup in the connector piece between the catheter and leg bag tubing.

            It seems that these clogs started coming after I cut way back on my alcohol consumption (from 3-4 times a week to 1-2 times a month). This issue may literally drive me to drink.

            I posted a question in this forum a couple days ago looking for what I thought were called 'super slick' indwelling Foley catheters (the only response I got suggested hydrophilic/lofric caths, but best I can tell they are only made for intermittent cathing). Also, I don't have UTI problems ever (maybe once a year at most).
            Maybe light beer is the cure all lol! I found these Silver caths I was planning to try out too. http://www.allegromedical.com/cathet...e-p172468.html



            Boy! With all that something should work lol! Other than that thanks so far and I will keep you all posted on my discoveries.
            Last edited by Padred123; 20 Jan 2012, 4:54 PM.
            C5/6 since Feb '07

            Comment


              #7
              Stay away from latex and switch to silicone catheter and bags. Change the bag q3 days and rinse with vinegar and hang to drip dry. Ask the doc for an order to irrigate the bladder with sterile water and a little baking soda. Change all meds to liquid and if not possible crush meds and add warm water and make sure fully dissolved before taking. Powder in is powder out. Make sure you are not taking too much tylenol/powdery substance this adds to a lot of stone issues.

              Comment


                #8
                "Powder in, powder out" makes the most sense to me. I've been taking lots of BCAA to help heal a tissue wound.

                It seems crazy to me that we need a doctor's order/prescription to get sterile saline (for irrigation).

                Comment


                  #9
                  Originally posted by QuadNurse View Post
                  Stay away from latex and switch to silicone catheter and bags. Change the bag q3 days and rinse with vinegar and hang to drip dry. Ask the doc for an order to irrigate the bladder with sterile water and a little baking soda. Change all meds to liquid and if not possible crush meds and add warm water and make sure fully dissolved before taking. Powder in is powder out. Make sure you are not taking too much tylenol/powdery substance this adds to a lot of stone issues.
                  Latex catheters are always a bad idea for long term use. At least use silastic or teflon coated if you must use them. Not everyone likes silcone.

                  There is no evidence that vinegar is a good disinfection agent...in fact, a study I participated in back in the 1980s found that vinegar actually promotes the grown of pseudomonas bacteria. The solution recommend for cleaning and disinfecting catheter bags is 10% bleach. Renacidin instillations (not irrigation) will help dissolve encrustations.

                  Irrigation with baking soda, which would make the bladder more alkaline, not acidic, also has no scientific basis and would not be recommended in this circumstance.

                  There is no scientific basis for crushing all meds or taking in a liquid form only as having any bearing on their efficacy or the formation of sediment. Many meds should NOT be crushed (timed release capsules or enteric coated tablets, for example).

                  Early forming stones may not show up in a regular Xray, as they are not fully calcified. A CT or ultrasound may find these early formers, which can still be quite large.

                  (KLD)
                  The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                  Comment


                    #10
                    Originally posted by Padred123 View Post
                    Thanks for the info GJ! My Dr only had me on the Keflex for 5 days. I got off of it Dec 29.
                    There's at least part of the problem -- your doctor is treating you as though you're an AB, not someone with a neurogenic bladder. For those of us with SCI/D, every symptomatic UTI should be treated as ''complex'', which means 10-14 days of antibiotics rather than the 5-7 day course of treatment recommended for ''simple'' UTIs.

                    Do yourself a favor and download this booklet about bladder management and give it to your doctor.
                    It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.

                    ~Julius Caesar

                    Comment


                      #11
                      Originally posted by thehipcrip View Post
                      There's at least part of the problem -- your doctor is treating you as though you're an AB, not someone with a neurogenic bladder. For those of us with SCI/D, every symptomatic UTI should be treated as ''complex'', which means 10-14 days of antibiotics rather than the 5-7 day course of treatment recommended for ''simple'' UTIs.

                      Do yourself a favor and download this booklet about bladder management and give it to your doctor.
                      Thanks. I will print it out. I'm a lil afraid I might insult him but at this point who cares. I might actually get a second opinion. I need to do something because everything I'm doing isn't working. I've changed about 5 catheters since my last post. This is completely discouraging. I feel like I'm at the end of my rope. I've read so much and the more I read the more hopeless it seems. According to the studies I've read proteus mirabilis is near impossible to get rid of.

                      Although there is some promise of fighting it off by filling the catheter balloon with triclosan but I'm still not sure of how many studies there has been. Drinking alot of water and lemon/lime drinks(which I do) is supposed to slow growth a little bit. I've started my own test by using 100% silicone catheters and filling the balloon with diluted vinegar since the encrustations can only grow in a ph 7 or greater but we'll see..

                      Also, I tried the silver cath but it only lasted two days then clogged like the rest of them(what a waste of $15) and I haven't ordered the vetericyn but I will very soon.

                      Heres some more good reading on proteus mirabilis.
                      Last edited by Padred123; 29 Jan 2012, 9:26 PM.
                      C5/6 since Feb '07

                      Comment


                        #12
                        Get the Vetericyn by all means, but IMO your best shot will be using it in conjunction with a 14 day course of antibiotics to which the proteus is sensitive.

                        Hang in there, man, it can be beaten. I spent a year battling alternating infections with proteus and pseudomonas. There wasn't one antibiotic to which both bugs were sensitive. I'd successfully treat one and three weeks later be infected with the other. After the ninth infection, I finally convinced my doc to give me the antibiotics that we'd been treating these two bugs with at the same time. It wasn't an easy solution, but it did get me off that carousel.

                        While I realize that any drug that shows up on the 'sensitive' list of the C&S should effectively treat the infection*, I always ask my doc to prescribe one of the less commonly used antibiotics. For example, the strain of proteus that plagued me was sensitive to Ceftin (cefuroxime), which I'd not taken in years. You might ask your doc to prescribe something different this time around.
                        It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.

                        ~Julius Caesar

                        Comment


                          #13
                          Not always taking the same antibiotic is a good idea. It helps to keep the bacteria "guessing". Make sure that you are drinking plenty of water. Stay away from latex catheters. And it doesn't hurt to get a second opinion. If your physician gets upset about information regarding a condition he/she may not be familiar with, then I would consider getting a different doctor.
                          KCF
                          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                          Comment


                            #14
                            Thanks for the encouragement HipCrip & SCI nurse! Its good to know that someones won the battle. I'll keep you posted.
                            C5/6 since Feb '07

                            Comment


                              #15
                              The leakage is still going on! I am getting fed up with this

                              I have increased the Diropan dosage up to 20 mg, but it is not helping.

                              I am changing the supra pubic catheter often, still the same problem; the only difference, now, it is not leaking only when I am in wheelchair, however, when I am sleeping too

                              I have changed the size of the catheter, it didn't help!

                              Please Help!

                              Comment

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