Help understanding culture results

To be honest, I never took a microbiology course in my life - it is all experiential - and I do a bit of research from time to time.

There are some exceedingly slow-growing mycobacteria, but as far as I know, none is a threat to our lungs. (Over 100 types have been isolated, but there is little research on many of them.) There are also some slow-growing nocardia and rhodococcus, but these are mainly threats in immunocompromised people. I'm not sure how long they take to grow.

Like your daughter explained, almost every culture yields surprises. Most are not known to be a problem in humans, and are often omitted in the pathology results we see om My Chart.

What does your doc have to say about the "mystery bug"? Curious (aka nosy" minds would like to know.
Sue

Sue- Interesting procedure with the chance it is an "infectious disease."
No I haven't had an issue with test submissions, so far.
I am waiting to see if Medicare approves the vest. I am doing it twice a day on a level comfortable for me.
My first sputum tests were done at NJH in October 2023 and it was the three separate days of submission. With my decision to go to Tyler rather than back to NJH, (due to distance/travel) the next sputum test done for submission was not until February 2024. I am waiting for results and hoping for the best.
In giving it thought after your post(s) I wonder(ed) if NJH was an exception with having Medicare approve and pay for more than one submission, being the facility that it is.
I was told I had a small amount of Mycobacterium avium-intracellulare (MAI) in three out of four specimens given at NJH. Dr. L, at NJH, felt it wasn't necessary to start the anti-biotic at that time. I was also to start the 7% saline solution and vest when I arrived home after the NJH visit in October, which I have done. So that also probably came into play with not starting the anti-biotic. I realize why their philosphy is somewhat a wait and see due to the anti-biotic resistance possibility down the line. Hope not starting the anti-biotic that was the right call for me. I haven't had an exacertation...no chills, fever, dark sputum etc. etc.
I will inquire with Tyler about three days of consecutive sputum samples and the procedure you outlined so I can fully understand how they handle it or will handle it.
Again, I like the idea of three consective days of preparting sputum culture samples. I feel, and I may be wrong, this would allow for a better chance of getting a good culture sample for testing.
P.S. At this juncture I am not doing much in the landscape other than 'directing' . I am lucky to have found someone who will help me with it. However, it is so difficult emotionally not doing some of it myself. Maybe once I get a better feel for everything I am learning, and as well, my trying to figure out the best ways to handle my daily tasks and routines to do things, I will allow myself to do more in the flower beds. Routines, such as you have mentioned, remembering to leave the shoes on the rug at the patio door when I come in. 😁 I am also trying to teach myself to accept things he does that might be exactly like I want or expected. 🤔
All thoughts or suggestions you have given are most welcomed and appreciated.
I am so glad you had/took the time to respond.
So for now, hello daffodils and Spring!
Thanks Sue.

Sue’s detailed explanations are incredibly helpful and thought-provoking!!

I brought in 3 samples when I was initially diagnosed with bronchiectasis to determine whether I had any culturable bugs. Now, quarterly, I try to bring in a sample because sometimes we can have something going on and might not have any symptoms. Another scenario is that not all lung bacteria are culturable. For example, the mouth has over 700 bacteria and many of these commensals end up in the lungs. They are identified through high-level genetic testing like the research done in Dr. Leo Segal’s lab at NYU Langone.

Two years ago, I was producing a bit more sputum on a regular basis. I was patting myself on the back for doing excellent airway clearance. This went on for a while and I submitted a couple of samples over time and nothing grew. BUT, about 8 months into this period, I went for my routine pulmonary appointment and I cultured haemophilus. My doctor and I discussed it and I asked to submit a sample again before taking antibiotics. It grew again and I took antibiotics. By the third day of taking the medication, practically all mucus disappeared and unless I have a cold that is now my norm (yes, I continue with daily airway clearance:)).

So, why all this detail? Because it is possible that the antibiotic killed another bug or bugs that were causing the mucus and were unidentified through culture. I don’t think it was the haemophilus because right along I was not growing it.

I discussed this theory with Dr Segal at the World Bronchiectasis Conference and he said it was plausible. Jokingly, I offered him a sputum sample and he said that he would have needed samples over a longer period of time to know what was truly going on. This is where lung health is headed. Knowing an individual’s microbiomes - skin, mouth, lungs and gut - and when for that person there is dysbiosis (the type and quantity of bugs are off) and fixing it! Precision medicine at its best.

Happy Sunday,
Linda Esposito

Sue’s detailed explanations are incredibly helpful and thought-provoking!!

I brought in 3 samples when I was initially diagnosed with bronchiectasis to determine whether I had any culturable bugs. Now, quarterly, I try to bring in a sample because sometimes we can have something going on and might not have any symptoms. Another scenario is that not all lung bacteria are culturable. For example, the mouth has over 700 bacteria and many of these commensals end up in the lungs. They are identified through high-level genetic testing like the research done in Dr. Leo Segal’s lab at NYU Langone.

Two years ago, I was producing a bit more sputum on a regular basis. I was patting myself on the back for doing excellent airway clearance. This went on for a while and I submitted a couple of samples over time and nothing grew. BUT, about 8 months into this period, I went for my routine pulmonary appointment and I cultured haemophilus. My doctor and I discussed it and I asked to submit a sample again before taking antibiotics. It grew again and I took antibiotics. By the third day of taking the medication, practically all mucus disappeared and unless I have a cold that is now my norm (yes, I continue with daily airway clearance:)).

So, why all this detail? Because it is possible that the antibiotic killed another bug or bugs that were causing the mucus and were unidentified through culture. I don’t think it was the haemophilus because right along I was not growing it.

I discussed this theory with Dr Segal at the World Bronchiectasis Conference and he said it was plausible. Jokingly, I offered him a sputum sample and he said that he would have needed samples over a longer period of time to know what was truly going on. This is where lung health is headed. Knowing an individual’s microbiomes - skin, mouth, lungs and gut - and when for that person there is dysbiosis (the type and quantity of bugs are off) and fixing it! Precision medicine at its best.

Happy Sunday,
Linda Esposito

Sue’s detailed explanations are incredibly helpful and thought-provoking!!

I brought in 3 samples when I was initially diagnosed with bronchiectasis to determine whether I had any culturable bugs. Now, quarterly, I try to bring in a sample because sometimes we can have something going on and might not have any symptoms. Another scenario is that not all lung bacteria are culturable. For example, the mouth has over 700 bacteria and many of these commensals end up in the lungs. They are identified through high-level genetic testing like the research done in Dr. Leo Segal’s lab at NYU Langone.

Two years ago, I was producing a bit more sputum on a regular basis. I was patting myself on the back for doing excellent airway clearance. This went on for a while and I submitted a couple of samples over time and nothing grew. BUT, about 8 months into this period, I went for my routine pulmonary appointment and I cultured haemophilus. My doctor and I discussed it and I asked to submit a sample again before taking antibiotics. It grew again and I took antibiotics. By the third day of taking the medication, practically all mucus disappeared and unless I have a cold that is now my norm (yes, I continue with daily airway clearance:)).

So, why all this detail? Because it is possible that the antibiotic killed another bug or bugs that were causing the mucus and were unidentified through culture. I don’t think it was the haemophilus because right along I was not growing it.

I discussed this theory with Dr Segal at the World Bronchiectasis Conference and he said it was plausible. Jokingly, I offered him a sputum sample and he said that he would have needed samples over a longer period of time to know what was truly going on. This is where lung health is headed. Knowing an individual’s microbiomes - skin, mouth, lungs and gut - and when for that person there is dysbiosis (the type and quantity of bugs are off) and fixing it! Precision medicine at its best.

Happy Sunday,
Linda Esposito