Industry of interest: Healthcare
Microbiology: P. aeruginosa is a Gram-negative motile rod capable of causing infection in almost all of the body’s tissues. P. aeruginosa utilises a variety of virulence factors and can produce biofilms to aid attachment and dispersal and uses its flagella and pili to establish infections in the host (Lyczak et al., 2000). P. aeruginosa infections are often associated with blue/green pus or exudates with a characteristic musky odour (Vitakauskiene et al., 2010).
Habitat and transmission: P. aeruginosa is ubiquitous in the environment and is frequently isolated from water, soil and decomposing vegetation. The organisms can grow in many different ecological niches due to its ability to utilise many different energy sources (Lyczak et al., 2000). It can also thrive on surfaces such as medical equipment and in-dwelling medical devices such as catheters (Vitakauskiene et al., 2010).
Treatment and antibiotic resistance: Most P. aeruginosa strains are susceptible to antibiotics such as 3rd generation cephalosporins, carbapenems, aminoglycosides, aztreonam, and colistin (Høiby, 2011; Vitakauskiene et al., 2010). Mucoid strains of P. aeruginosa that can produce biofilms are protected from the effects of antibiotics and are difficult to treat effectively. In order to treat P. aeruginosa lung infection in cystic fibrosis patients, aggressive prophylactic antibiotic treatment and suppressive therapies are required to minimise symptoms (Høiby, 2011). Nebulised antibiotics and experimental vaccines may also be useful for the prophylaxis and treatment of P. aeruginosa lung infections in cystic fibrosis patients (Vitakauskiene et al., 2010). Antibiotic-resistant P. aeruginosa strains are on the increase, particularly in the hospital environment. In fact multidrug-resistant strains of P. aeruginosa are emerging that are incredibly difficult to treat using currently available antibiotics.
Prevention and control: P. aeruginosa is commonly associated with wet areas such as sinks and showers, particularly in hospitals. It is therefore important to ensure that these areas are thoroughly cleaned and disinfected. Regular infection control procedures such as stringent hand-hand hygiene, environmental decontamination, patient isolation, contact precautions and prudent usage of antibiotics all reduce the transmission of P. aeruginosa in hospitals.
Disease and symptoms: P. aeruginosa infection can manifest in many different forms. It commonly causes urinary tract infections, skin infections, pneumonia, meningitis, diarrhoea, wound infections and respiratory infections (Vitakauskiene et al., 2010). People at particular risk of P. aeruginosa infection include burns patients, the immunocompromised and people with cystic fibrosis (Lyczak et al., 2000). Because of the ubiquitous nature of the organism, burns victims are particularly susceptible to P. aeruginosa infection. If the organism enters the bloodstream it can then cause bacteraemia. P. aeruginosa infection is also a problem for those with cystic fibrosis, causing chronic lung infections. P. aeruginosa has also been linked to folliculitis infections associated with hot tub use (Vitakauskiene et al., 2010).
Lyczak J.B., Cannon C.L. and Pier G.B. (2000) Establishment of Pseudomonas aeruginosa infection: lessons from a versatile opportunist. Microbes and infection. 2(9): 1051-1060.
Høiby N. (2011) Recent advances in the treatment of Pseudomonas aeruginosa in cystic fibrosis. BMC Med. 4:9:32.
Vitakauskiene A., Skrodeniene E., Dambrauskiene A, Macas A. and Sakalauskas R. (2010) Pseudomonas aeruginosa bacteremia: resistance to antibiotics, risk factors, and patient mortality. Medicina (Kaunas). 46(7): 490-495.
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