Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-02T23:35:40.574Z Has data issue: false hasContentIssue false
  • English
  • Français

Pseudomonas aeruginosa Revisited

Published online by Cambridge University Press:  21 June 2016

Charles W. Stratton
Charles W. Stratton*
Affiliation:
Department of Pathology, Vanderbilt University School of Medicine, Nashville, Tennessee
*
Associate Professor of Pathology, Vanderbilt University School of Medicine, Nashville, TN 37232-2561
Get access Rights & Permissions [Opens in a new window]

Extract

Pseudomonas aeruginosa previously has been reviewed in “Topics in Clinical Microbiology.” However, the increased importance of this micro-organism in nosocomial infections as well as new information on pathogenic mechanisms is such that this topic should be “revisited.” For example, the ubiquitous presence of this bacterium in nature and its ability to survive in hostile environments has been recently emphasized by episodes of P aeruginosa peritonitis, bacteremia and pseudobacteremia that have been linked to contaminated povidone-iodine. Clearly, P aeruginosa is an important pathogen and is deserving of careful and deliberate consideration.

The role of P aeruginosa as a nosocomial pathogen in hospitalized patients with critical illness is rapidly increasing. Recent data from the Centers for Disease Control (CDC) have shown that while nosocomial infections from Escherichia coli and Klebsiella have remained relatively constant from 1975 to 1984, the proportion of such infections caused by Pseudomonas has risen from 6.3% in 1975 to 11.4% in 1984. The frightening aspect of this epidemiologic data is the extremely high rate of mortality associated with hospital-acquired Pseudomonas infections. For example, the mortality rate for Pseudomonas bacteremia often ranges from 67% to 90% for neutropenic cancer patients. Among more general hospital patient populations, the mortality rate for Pseudomonas bacteremia can be similar depending on the underlying condition of the host.

Type
Special Sections
Information
Infection Control & Hospital Epidemiology , Volume 11 , Issue 2 , February 1990 , pp. 101 - 104
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Stratton, CW. Pseudomonas aeruginosa. Infect Control. 1983;4:36–40.10.1017/S0195941700057647CrossRefGoogle ScholarPubMed
2. Goetz, A, Muder, RR. Pseudomonas aeruginosa infections associated with use of povidone-iodine in patients receiving continuous ambulatory peritoneal dialysis. Infect Control Hosp Epidemiol. 1989;10:447–450.10.2307/30146833Google Scholar
3. Blotzenhart, K, Ruden, H. Hospital infections caused by Pseudomonas aeruginosa . Antibiot Chemother 1987;39:1–15.10.1159/000414328CrossRefGoogle Scholar
4. Bodley, GP, Bolivar, R, Fainstein, V, et al. Infections caused by P aeruginosa . Rev Infect Dis. 1986;5:279–313.10.1093/clinids/5.2.279CrossRefGoogle Scholar
5. Flick, MR, Cliff, LE. Pseudomonas bacteremia; review of 108 cases. Am J Med. 1976;60:501–508.10.1016/0002-9343(76)90716-6Google Scholar
6. Hilf, M, Yu, VL, Sharp, J, Zuravleff, JJ, Korvick, JA, Muder, RR. Anti-biotic therapy for Pseudomonas aeruginosa bacteremia: outcome correlations in a prospective study of 200 patients. Am J Med. 1989;87:540–546.10.1016/S0002-9343(89)80611-4CrossRefGoogle Scholar
7. Bisbe, J, Gatell, JM, Puig, J, et al. Pseudomonas aeruginosa bacteremia: univariate and multivariate analysis of factors influencing the prognosis in 133 episodes. Rev Infect Dis. 1988;10:629–635.10.1093/clinids/10.3.629Google Scholar
8. Drake, D, Montie, TC. Flagella, motility, and invasive virulence of Pseudomonas aeruginosa . J Gen Microbiol. 1988:134:43–52.Google Scholar
9. Kessner, DM, Lepper, MH. Epidemiologic studies of gram-negative bacilli in the hospital and community. Am J Epidemiol. 1967;85:45–60.10.1093/oxfordjournals.aje.a120674Google Scholar
10. Rosenthal, S, Tager, IB. Prevalence of gram-negative rods in the normal pbaryngeal flora. Ann Intern Med. 1975;83:355–357.10.7326/0003-4819-83-3-355Google Scholar
11. Kominos, SD, Copeland, CE, Grosiak, B, et al. Introduction of Pseudomonos aeruginosa into a hospital via vegetables. Applied Microbiol. 1972;24:567–570.10.1128/am.24.4.567-570.1972Google Scholar
12. Doig, P, Todd, T, Sastry, PA, et al. Role of pili in adhesion of Pseudomonas aeruginosa to human respiratory epithelial cells. Infect Immun. 1988;56:1641–1646.10.1128/iai.56.6.1641-1646.1988Google Scholar
13. Russell, NJ, Gacesa, P Chemistry and biology of the alginate of mucoid strains of Pseudomonas aeruginosa in cystic fibrosis. Mel Aspects Med. 1988:10:1–91.10.1016/0098-2997(88)90002-7Google Scholar
14. Meshulam, T, Obedeanu, N, Merzbach, D, et al. Phagocytosis of mucoid and non-mucoid strains of Pseudomonas aeruginosa . Clin Immunol Immunopathol. 1984;321:151–165.10.1016/0090-1229(84)90117-XGoogle Scholar
15. Woods, DE, Iglewski, BH. Toxins of Pseudomonas aeruginosa: new perspectives. Rev Infect Dis. 1983;5:S715–S722.10.1093/clinids/5.Supplement_4.S715Google Scholar
16. Döring, G, Maier, M, Miiller, E, et al. Virulence factors of Pseudomonas aeruginosa . Antibiot Chemother. 1987; 39:136–148.10.1159/000414341Google Scholar
17. Teres, D, Schweers, P, Bushnell, LS, et al. Sources of Pseudomonas aeruginosa infection in a respiratory/surgical intensive therapy unit. Lancet. 1973;1:415–417.10.1016/S0140-6736(73)90266-3Google Scholar
18. Shirani, K, McManus, A, Vaughan, G, et al. Effects of environment on infection in bum patients. Arch Surg. 1986;121:31–36.10.1001/archsurg.1986.01400010037003Google Scholar
19. Stratton, CW, Tausk, C. Intrinsic resistance of Pseudomonas aeruginosa . Antibiot Chemother 1989;42:275–286.10.1159/000417630CrossRefGoogle ScholarPubMed
20. Greenwood, D. Phenotypic resistance to antimicrobial agents. J Antimicrob Chemother 1985;15:653–658.10.1093/jac/15.6.653Google Scholar
21. Bryan, LE. Two forms of antimicrobial resistance: bacterial persistence and positive function resistance. J Antimicrob Chemother. 1989:23:817–823.10.1093/jac/23.6.817CrossRefGoogle ScholarPubMed
22. Stratton, CW, Tausk, F. Synergistic resistant mechanisms in Pseudomonas aeruginosa . J Antimicrob Chemother 1987;19:413–416.10.1093/jac/19.4.413Google Scholar
23. Robillard, NJ, Scarpa, L. Genetic and physiologic resistance in Pseudomonas aeruginosa PAO. Antimicrob Agents Chemother. 1988;32:535–539.CrossRefGoogle ScholarPubMed
24. Quinn, JP, Studemeister, AE, DiVincenzo, CA, et al. Resistance to imipenem in Pseudomonas aeruginosa. Clinical experience and bio-chemical mechanisms. Rev Infect Dis. 1988; 35:1267–1268.Google Scholar
25. Mawer, SL, Greenwood, D. Aminoglycoside resistance emerging during therapy Lancet. 1977;i:749–750.Google Scholar
26. Shannon, K, King, A, Phillips, I. Development of resistance to beta-lactam antibiotics during therapy of Pseudomonas aeruginosa infections. Lancet. 1982;i:1466.10.1016/S0140-6736(82)92473-4Google Scholar
27. Ogle, JW, Reller, LB, Vasil, ML. Development of resistance in Pseudomonas aeruginosa to imipenem, norfloxacin, and ciprofloxacin during therapy: proof provided by typing with a DNA probe. J Infect Dis. 1988;157:743–748.10.1093/infdis/157.4.743CrossRefGoogle ScholarPubMed
28. Bodey, GP, Jadeja, L, Elting, L. Pseudomonas bacteremia; a retrospective analysis of 410 episodes. Arch Intern Med. 1985; 145:1621–1629.10.1001/archinte.1985.00360090089015Google Scholar
29. Baltch, AL, Smith, Rl? Combination of antibiotics against Pseudomonas aeruginosa . Am J Med. 1985;79(Suppl 1A):8–18.10.1016/0002-9343(85)90185-8Google Scholar
30. Andriole, VT Synergy of carbenicillin and gentamicin in experimental infection with Pseudomonas . J Infect Dis. 1971;124(Suppl):S46–S55.10.1093/infdis/124.Supplement_1.S46Google Scholar
31. Klastersky, J, Cappel, R, Daneau, D. Therapy with carbenicillin and gentamicin for patients with cancer and severe infections caused by gram-negative rods. Cancer. 1973;31:331–336.10.1002/1097-0142(197302)31:2<331::AID-CNCR2820310210>3.0.CO;2-S3.0.CO;2-S>CrossRefGoogle ScholarPubMed
32. Martin, NL, Beveridge, TJ. Gentamicin interaction with Pseudomonas aeruginosa cell envelope. Antimicrob Agents Chemother. 1986;29:1079–1087.10.1128/AAC.29.6.1079CrossRefGoogle ScholarPubMed
33. Nichols, NW, Dorrington, SM, Slack, MPE, et al. Inhibition of tobramycin diffusion by binding to alginate. Antimicrob Agents Chemother. 1988;32:518–523.10.1128/AAC.32.4.518Google Scholar
34. Fong, IW, Tompkins, KB. Review of Pseudomonas aeruginosa meningitis with special emphasis on treatment with ceftazidime. Rev Infect Dis. 1985;7:604–612.Google Scholar
35. Rice, LB, Willey, SH, Medeiros, AA, Eliopoulos, GM, Moellering, RC, Jacoby, GA Outbreak of ceftazidime-resistant gram-negative bacilli in a Massachusetts chronic care facility. Abstract A-64. Presented at the Annual Meeting for the American Society for Microbiology, New Orleans, LA, 1989.Google Scholar
36. Bush, K. Recent developments in β-lactamase research and the implications for the future. Rev Infect Dis. 1988;10:681–691.10.1093/clinids/10.4.681Google Scholar
37. Toews, GB. Nosocomial pneumonia. Clin Chest Med. 1987;8:467–479.10.1016/S0272-5231(21)01041-8Google Scholar
38. Peloquin, CA, Cumbo, TJ, Nix, DE, Sands, MF, Schentag, JJ. Evaluation of intravenous ciprofloxacin in patients with nosocomial lower respiratory tract infections. Arch Intern Med. 1989;149:2269–2273.10.1001/archinte.1989.00390100083020Google Scholar
39. Stratton, CW, Franke, JJ, Weeks, LS, Manion, FA. Comparison of the bactericidal activity of ciprofloxacin alone and in combination with selected antipseudomonal β-lactam agents against clinical isolates of Pseudomonas aeruginosa . Diag Microbiol Infect Dis. 1989;11:41–52.10.1016/0732-8893(88)90072-7Google Scholar
40. Fu, KP, Lasinski, ER, Zoganas, HC, et al. Efficacy of rifampin in experimental Bacteroides fragilis and Pseudomonas aeruginosa mixed infections. J Antimicrob Chemother. 1985;15:579–585.Google Scholar
41. Yu, VL, Zuravleff, JJ, Peacock, JE, et al. Addition of rifampin to carboxypenicillin for the treatment of Pseudomonas aeruginosa infection. Clinical experience with four patients. Antimicrob Agents Chemother. 1984;26:575–577.10.1128/AAC.26.4.575Google Scholar
42. Stübner, G. Indirect evidence of cell wall alterations in Pseudomonas aeruginosa by immunoglobulin preparations. Infection. 1984;12:75–76.10.1007/BF01640910Google Scholar
43. Dalhoff, A. Synergy between acylureido-penicillins and immunoglobulin G in experimental animals. Am J Med. 1984;76:168–174.10.1016/0002-9343(84)90326-7Google Scholar