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    Pseudomonas at SPC site

    I have had a SPC for over 10 year. 6 months ago, for the first time ever, I got a green discharge from SPC. A swab and culture confirmed it's Pseudomonas.

    Because of recurrent UTIs I've taken strong antibiotics, including IV antibiotics, and while the discharge goes away temporarily it always comes back in a week or 2.

    I am keeping it at bay with a heavy betadine routine, but I'd like to kill whatever bug I have for good!

    Any ideas? Ideally, I don't want to have to remove the SPC, let the site heal, and then put in a new one.

    Thanks.
    Chris.
    Have you ever seen a human heart? It looks like a fist wrapped in blood! Larry in 'Closer', a play by Partick Marber

    #2
    I would avoid Betadine, as it can damage granulation tissue. Local daily application of 2% CHG (chlorhexidine gluconate) would be worth a try. Silvadene cream could also be tried, although it is kind of messy.

    There is no reason to remove and close the SP stoma. It is likely you have a drug resistant strain of pseudomonas (did the C&S indicated this). Do you also have chronic pseudomonas colonization of your urine?

    (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.

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      #3
      Members on this forum have reported some incredible results by switching to the Duette catheter by Poiesis. Some have said that their stomas are in better shape than they have ever been. Others say they have experienced less sediment and clogging of the catheter, increased urine output, fewer spasms, and a generally more comfortable experience. The Duette catheters have an anchor balloon and a cushioning balloon, with the drainage eyelets in between the balloons.

      Poiesis will send you free samples. For more information see: http://www.poiesismedical.com/products/duette/

      Have you tried cleaning the stoma with HydroCleanse or MicrocynAH?

      All the best,
      GJ

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        #4
        Thanks both KLD and gjnl for your replies. For the last 5-6 years I've had no end of recurrent UTIs which have now stabilised by me taking 2 Ural sachets in the morning and at night (Ural is a urinary alkaniser available in Australia). The change in my urine over the past 6 months has been fantastic. Now I just need to fix the discharge.

        I will look into chlorhexidine gluconate. I have always put betadine around the stoma site, but recently started pushing it into the stoma to help kill the pseudomonas. It helps, but if I put too much in I eventually get a little bleeding. I guess it really does damage granulation tissue. I will phase it out.

        The pseudomonas is likely drug-resistant. My urine is no doubt colonised, but I don't know if it's pseudomonas or another bug. I'm guessing it is pseudomonas. I get a white film on my leg bag tubing and a sulphur smell around day 4. I change my leg bags every 5 days, so it's no biggie. I don't want to take any antibiotics until I'm symptotic. I change my SPC every 4 weeks - without the Urals I would get a full blown UTI in that 4 weeks.

        I suggested removing my SPC to kill the pseudomonas to my rehab specialist. We both think it will work, but it's a last resort (hence posting here!). I will try KLD's suggestion and explore the Duette catheter before doing anything too rash.

        Chris.
        Have you ever seen a human heart? It looks like a fist wrapped in blood! Larry in 'Closer', a play by Partick Marber

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