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Pseudomonas aeruginosa is a Gram-negative opportunistic pathogen that causes various infections, particularly in immunocompromised individuals, including sepsis, pneumonia, and urinary tract infections. It is characterized by its ability to thrive in low-nutrient environments and its resistance to many antibiotics, making treatment challenging. Prevention strategies focus on maintaining host defenses and minimizing exposure in vulnerable patients.

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4 views

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Pseudomonas aeruginosa is a Gram-negative opportunistic pathogen that causes various infections, particularly in immunocompromised individuals, including sepsis, pneumonia, and urinary tract infections. It is characterized by its ability to thrive in low-nutrient environments and its resistance to many antibiotics, making treatment challenging. Prevention strategies focus on maintaining host defenses and minimizing exposure in vulnerable patients.

Uploaded by

saqiblym
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Pseudomonas

Shah Faisal Jamal


KMU-IPMS
Pseudomonas
Diseases
 Sepsis, penumonia and UTI in lowered host defenses
 Chronic lower respiratory tract infections in patients
with cystic fibrosis and cellulitis in burn patients
 Malignant otitis externa in diabetic patients.
 Most common cause of ventilator associated penumonia
Characteristics
 Gram negative rods, strict aerobes, motile, oxidase
positive, can grow in water containing only traces
nutrients, ability to withstand disinfectants and able to
grow in hexachlorophene-containing soap solutions,
antiseptics and detergents
 P. aeruginosa produces two pigments
1. pyocyanin, (P. Aeruginosa) which can color the pus in a wound blue
2. pyoverdin (fluorescein), a yellow-green pigment
Habitate and Transmission
Found in environment, 10% people carry it as normal flora.
Its ability to grow in simple aqueous solutions has resulted
in contamination of respiratory therapy and anesthesia
equipment, intravenous fluids, and even distilled water
P. aeruginosa is primarily an opportunistic pathogen that
causes infections in
 hospitalized patients (e.g., those with extensive burns)
 in whom the skin host defenses are destroyed;
 in those with chronic respiratory disease (e.g., cystic fibrosis),
 in whom the normal clearance mechanisms are impaired;
 in those who are immunosuppressed;
 in those with neutrophil counts of less than 500/mL
 in those with indwelling catheters.
Pathogenesis/Clinical Significance
P. aeruginosa disease begins with attachment (by pili) and
colonization of host tissue, virtually any tissue/organ may
be affected
Virulence factors include endotoxin, exotoxin and enzymes,
endotoxin causes sepsis and septic shock
Exotoxin A causes tissue necrosis by ADP-ribosylation of
elongation factor-2
Produces enzymes, such as elastase and protease that are
histotoxic and facilitate invasion
Pyocyanin damages cilia and mucosal cells of repiratory
tract
Strains of P. aeruginosa that have a “type III secretion
system” which transfer exotoxin form bacterium directly
into adjacent human cell
Exo S is the one most clearly associated with virulence
which is ADPribosylation of a Ras protein, leading to
Pathogenesis/Clinical Significance
 P. aeruginosa can cause infections virtually anywhere in
the body but urinary tract infections, pneumonia and
wound infections predominate
 It is an important cause of hospital-acquired pneumonia.
 From these sites, the organism can enter the blood,
causing sepsis, can spread to the skin causes black
necrotic lesions called ecthyma gangrenosum.
 It is an important cause of endocarditis in intravenous
drug users
 Severe external otitis and other skin lesions (e.g.,
folliculitis) occur in users of swimming pools and hot
tubs in which the chlorination is inadequate.
 Osteochondritis of the foot in person with sustain
puncture wound through soles of gym shoes and
corneal infection in contact lens users
Lab Diagnosis
Non–lactose-fermenting (colorless) colonies on
MacConkey’s or EMB agar, oxidase-positive. A
typical metallic sheen of the growth on TSI agar,
coupled with the blue-green pigment on ordinary
nutrient agar and a fruity aroma are sufficient to make
a presumptive diagnosis.
Treatment
P. aeruginosa is resistant to many antibiotics, the
treatment of choice is an antipseudomonal penicillin
(e.g., piperacillin/tazobactam or
ticarcillin/clavulanate) plus an aminoglycoside (e.g.,
gentamicin or amikacin)
For infections caused by highly resistant strains,
colistin (polymyxin E) is useful, ciprofloxacin is in UTI.
Prevention
Prevention of P. aeruginosa infections
involves keeping neutrophil counts above
500/mL, removing indwelling catheters
promptly, taking special care of burned skin,
and taking other similar measures to limit
infection in patients with reduced host
defenses.

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