Adam has a multi-antibiotic resistant (ESBL) form of Klebsiella Pneumoniae. We've changed to a completely different type of antibiotic that bacteria from Adam's blood culture displayed sensitivity to in the lab. Although the broad spectrum antibiotic he was on before has clearly had an immediate beneficial effect, if we continued on this path the bacteria would just up-regulate its resistance gene to overcome it.
We are now under isolation control, and had a visit from the infectious diseases team earlier this morning. All staff entering Adam's room must be gloved and gowned, whilst Alison and I are not allowed to enter the communal areas of the ward. Moreover, Adam will need to be gowned and isolated whilst in the hospital for the next six months to a year. Now we know Adam prefers to have his own room whenever possible, but as Alison told him earlier this is a rather extreme way to go about it.Adam's immune system remains very low; he is getting daily shots of G-CSF and it will be very important to see his white blood cell count improve over the coming days in order for him to fight off this infection as quickly as possible. We are still on track for a PET/CT scan tomorrow, but beyond that we don't yet know what impact this is going to have in terms of treatment. My instinct is a lot, but we'll see. It's anticipated that antibiotics will continue for the next ten to fourteen days. At present Adam remains reasonably well and has been afebrile since Friday evening, which is something at least.