Re: Ecoli in the Lungs
I'm sorry you've been having so much trouble with lung infections--that must be very difficult for you. Unfortunately, that is the pattern with people who suffer from bronchiectasis.
In people who have normal healthy lungs and who are NOT in hospital and who have NOT been exposed to antibiotics, when pneumonias happen they tend to be from gram POSITIVE organisms like pneumococcus or Staphylococcus....i.e. things that live on your skin. In people who have abnormal lungs, who've been on a lot of antibiotics or who sick in hospital, they tend to get gram NEGATIVE organisms. These bugs are the ones that live in your stool generally and E. coli is a very common one.
In your case, there are small amounts of E. coli in the mouth which are constantly inhaled in to the lungs, but these are taken care of by your immune system; however, in someone who has abnormal lung architecture as yourself, and has been on multiple courses of antibiotics, the E. coli is able to colonize the lungs, and the resistant ones are "selected out" because all the other bugs around them are being killed by the antibiotics while they themselves live. Given that you've probably had a lot of fluoroquinolone exposure, it's no surprise the E. coli is resistant.
It's a difficult situation in people who have chronic lung disease like COPD or bronchiectasis. You want to minimize antibiotic exposure as much as you can, but on the other hand, if the person is really ill and has a fever with increased cough and shortness of breath, you have no choice BUT to give antibiotics. That's why with bronchiectasis, as your respirologist has likely told you, it is very important to maintain all the activities that help to optimize drainage and try to PREVENT infections in the first place. There are many different things that can help do this, and I'm sure you know about all of them.
I have a bit of an unrelated question for you: alpha1 antitrypsin defiiciency generally results in panacinar emphysema rather than bronchiectasis. Do you have bronchiectasis for another reason on TOP of your A1ATD? Did you have a lot of lung infections when you were a kid? Did you have whooping cough when you were a kid?