scholarly journals Pseudomonas aeruginosa: Diseases, Biofilm and Antibiotic Resistance

2020 ◽  
Author(s):  
Hussein Al-Dahmoshi ◽  
Raad D. Al-Obaidi ◽  
Noor Al-Khafaji
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Blood Stream Infection ◽  
Surgical Site Infections ◽  
Blood Stream ◽  
Central Line ◽  
Resistance Mechanisms ◽  
Resistance Patterns ◽  
Tract Infections ◽  
Hospital Acquired

Pseudomonas aeruginosa is Gram negative bacteria that can adapt to extreme environmental conditions and withstand to different antibacterial agents. It si responsible for arrays of infections both community and hospital acquired especially ICU infections. Respiratory tract infection, blood stream infection, wound infection, burn infection, and urinary tract infections ware top five P. aeruginosa infections. Additionally as an opportunistic bacteria, it may be associated with healthcare infections in intensive care units (ICUs), ventilator-associated pneumonia (VAP), central line-associated blood stream infections, surgical site infections, otitis media, and keratitis. P. aeruginosa can form biofilms as self-produced extracellular matrix to protects the cells from antibiotics and the host immune response. Antibiotic resistance was an prominent feature of this pathogen and can donate it one of the three resistance patterns: Multidrug (MDR), extensive drug (XDR) and pan drug resistance. It exploit many resistance mechanisms ranged from overexpression of drug efflux systems protein, modifying enzyme production, reducing the permeability and using shelters like biofilms.

Totally antibiotic resistance Pseudomonas aeruginosa isolated from patients with blood stream infection

2021 ◽  
Author(s):  
Ali M. Hussein ◽  
Zhala B. Taha ◽  
Ahmed G. Malik ◽  
Dur K. Hazim ◽  
Reman J. Ahmed ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Blood Stream Infection ◽  
Blood Stream

scholarly journals Review of Ceftazidime-Avibactam for the Treatment of Infections Caused by Pseudomonas aeruginosa

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1126
Author(s):  
George L. Daikos ◽  
Clóvis Arns da da Cunha ◽  
Gian Maria Rossolini ◽  
Gregory G. Stone ◽  
Nathalie Baillon-Plot ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Real World Data ◽  
Serious Infections ◽  
Tract Infections ◽  
Abdominal Infections ◽  
Hospital Acquired

Pseudomonas aeruginosa is an opportunistic Gram-negative pathogen that causes a range of serious infections that are often challenging to treat, as this pathogen can express multiple resistance mechanisms, including multidrug-resistant (MDR) and extensively drug-resistant (XDR) phenotypes. Ceftazidime–avibactam is a combination antimicrobial agent comprising ceftazidime, a third-generation semisynthetic cephalosporin, and avibactam, a novel non-β-lactam β-lactamase inhibitor. This review explores the potential role of ceftazidime–avibactam for the treatment of P. aeruginosa infections. Ceftazidime–avibactam has good in vitro activity against P. aeruginosa relative to comparator β-lactam agents and fluoroquinolones, comparable to amikacin and ceftolozane–tazobactam. In Phase 3 clinical trials, ceftazidime–avibactam has generally demonstrated similar clinical and microbiological outcomes to comparators in patients with complicated intra-abdominal infections, complicated urinary tract infections or hospital-acquired/ventilator-associated pneumonia caused by P. aeruginosa. Although real-world data are limited, favourable outcomes with ceftazidime–avibactam treatment have been reported in some patients with MDR and XDR P. aeruginosa infections. Thus, ceftazidime–avibactam may have a potentially important role in the management of serious and complicated P. aeruginosa infections, including those caused by MDR and XDR strains.

scholarly journals Molecular Characteristics and Antimicrobial Susceptibility Profile of Pseudomonas aeruginosa isolated from patients attending Healthcare Facilities in Mthatha, South Africa

2020 ◽  
Author(s):  
Mojisola C. Hosu ◽  
Sandeep D. Vasaikar ◽  
Grace E. Okuthe ◽  
teke apalata
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Resistance Mechanisms ◽  
High Rate ◽  
Infection Prevention And Control ◽  
Molecular Characteristics ◽  
Mortality And Morbidity ◽  
Resistance Patterns

Abstract Background: Pseudomonas aeruginosa is a common pathogen causing healthcare-associated infections most especially in critically ill and immunocompromised patients. This pathogen poses a public health threat due to its innate resistance to many antimicrobial agents and its ability to acquire new resistance mechanisms under pressure. Infections with Extended spectrum β-lactamases (ESBL)‑producing isolates result into outbreaks that lead to serious antibiotic management concerns with higher mortality and morbidity and significant economic causatives. In this study, we evaluated the antimicrobial resistance patterns and characterized genetically the ESBLs and Metallo- β-lactamases (MBL) produced by this pathogen. Methods: Isolates of P. aeruginosa cultured from patients who attended Nelson Mandela Academic Hospital and other clinics in the four district municipalities of the Eastern Cape between August 2017 and May 2019 were identified; and their antibiotic resistance patterns were tested against amikacin, aztreonam, cefepime, ceftazidime, ciprofloxacin, doripenem, gentamicin, imipenem, levofloxacin, meropenem, piperacillin, piperacillin/tazobactam and tobramycin using the bioMérieux VITEK® 2 and confirmed by Beckman autoSCAN-4 System. Real-time PCR was done using Roche Light Cycler 2.0 to detect the presence of ESBLs; blaSHV, blaTEM and blaCTX-M genes; and MBLs; blaIMP, blaVIM. Results: High antibiotic resistance in decreasing order was observed in piperacillin (64.2%), aztreonam (57.8%), cefepime (51.5%), ceftazidime (51.0%), piperacillin/tazobactam (50.5%), and imipenem (46.6%). A total of 75 (36.8%) multidrug resistant (MDR) isolates were observed of the total pool of isolates. The blaTEM, blaSHV and blaCTX-M was detected in 79.3%, 69.5% and 31.7% isolates (n=82), respectively. The blaIMP was detected in 1.25% while no blaVIM was detected in any of the isolates tested. Conclusions: The study showed a high rate of MDR P. aeruginosa in our setting. The vast majority of these resistant isolates carried blaTEM and blaSHV genes. Continuous monitoring of antimicrobial resistance and strict compliance towards infection prevention and control practices are the best defence against spread of MDR P. aeruginosa.

scholarly journals 113. Accuracy of the NHSN Central Line-Associated Bloodstream Infection (CLABSI) Definition

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S3-S3 ◽  
Author(s):  
Ahmed Al Hammadi ◽  
Luis Ostrosky-Zeichner ◽  
Kelley Boston ◽  
Tawanna McInnis-Cole ◽  
John Butler
Keyword(s):  
Clinical Review ◽  
Healthcare System ◽  
Surgical Site Infections ◽  
Blood Stream ◽  
Central Line ◽  
Left Ventricular ◽  
Hospital Length Of Stay ◽  
Mucosal Barrier ◽  
Gastrointestinal Infections ◽  
Tract Infections

Abstract Background CLABSIs are serious infections that cause prolonged hospital length of stay, increased cost, and mortality. Acute care hospitals must report CLABSIs to NHSN to participate in CMS programs. NHSN definitions must be met to attribute a secondary BSI (SBSI), or bacteremia is defaulted to CLABSI if a central line is present. The lack of CDC/NHSN definitions for certain secondary sites of infections or problems in the definitions may lead to over-labeling CLABSIs. We reviewed the accuracy of NHSN definitions in a large healthcare system. Methods We retrospectively reviewed medical records of 279 patients with positive blood cultures on or after hospital day 3 and a central line from 15 hospitals belonging to a large healthcare system from January 1 to November 27, 2017. A team of centralized infection preventionists (IPs) adjudicated each case as a CLABSI or as SBSI through routine surveillance following NHSN methodology. A clinical review was performed by a PGY6 infectious diseases fellow. Descriptive statistics are presented. Results A total of 279 bacteremia cases were analyzed. Of those 279 patients, 237 (85%) were ≥18 years old, 162 (58%) were males, 92 (33%) were white, 62 (22.2%) were black, 5 (1.8%) were Asian, and 12 (4.3%) were “other.” Ninety-seven (34.8%) were from the reference hospital. IPs classified 171 CLABSIs and 108 as SBSI. Of the 171 CLABSIs classified by IPs, in 62 patients (36.3%), a primary site infection clinically explaining the BSI, but which did not meet the NHSN infection criteria, could be attributed as follows during the clinical review: 30 pneumonia, 6 urinary tract infections, 4 surgical site infections, 2 vascular infections, 2 mucosal barrier injury associated blood stream infections, 7 gastrointestinal infections, 1 decubitus ulcer infection, 4 skin and soft-tissue infections, 2 left ventricular-assisted device infections, 2 endocarditis, and 2 infected thrombi. Misclassification most often occurred due to missing elements of the definitions or infections not defined by NHSN. Conclusion Current NHSN definitions may overestimate CLABSIs by nearly 30%. As hospitals continue to work in CLABSI reduction, accurate and precise definitions/methodology will be key in focusing efforts and attention of the engaged parties and avoiding penalties. Disclosures L. Ostrosky-Zeichner, Cidara Therapeutics: Grant Investigator, Research grant.

Fever

2018 ◽  
pp. 176-179
Author(s):  
Sarah Morgan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Key Management ◽  
Complete Blood Count ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Central Line ◽  
Source Control ◽  
Empiric Antibiotics ◽  
Hospital Acquired

This chapter focuses on evaluation of a patient in the intensive care unit who develops fever in the setting of an indwelling central line and urinary catheter. Focus is on the development of a differential including central line associated blood stream infection, catheter-associated urinary tract infection, and hospital-acquired pneumonia as the most likely etiology of the patient’s decompensation. Emphasis is on rapid source control and treatment to control sepsis and decompensation to shock. Key management steps include consideration of the most likely sources of infection in the patient who develops fever while in the intensive care unit; securing a complete blood count, lactate, and blood cultures prior to empiric antibiotics; the rapid source control with removal and, if needed, replacement of indwelling lines; and administering appropriate empiric antibiotics within 6 hours of diagnosis of infection.

scholarly journals Auranofin inhibits virulence in Pseudomonas aeruginosa

2017 ◽  
Author(s):  
Leon Zhen Wei Tan ◽  
Joey Kuok Hoong Yam ◽  
Ziyan Hong ◽  
May Margarette Santillan Salido ◽  
Bau Yi Woo ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Quorum Sensing ◽  
Resistance Mechanisms ◽  
Type Iv Pili ◽  
Hospital Acquired Infections ◽  
Type Iv ◽  
Hospital Acquired ◽  
Virulence Regulator

AbstractPseudomonas aeruginosa is widely attributed as the leading cause of hospital-acquired infections. Due to intrinsic antibiotic resistance mechanisms and the ability to form biofilms, P. aeruginosa infections are challenging to treat. P. aeruginosa employs multiple virulence mechanisms to establish infections, many of which are controlled by the global virulence regulator Vfr. An attractive strategy to combat P. aeruginosa infections is thus the use of anti-virulence compounds. Here, we report the discovery that FDA-approved drug auranofin attenuates virulence in P. aeruginosa. We demonstrate that auranofin acts by targeting Vfr, which in turn leads to inhibition of quorum sensing (QS) and Type IV pili (TFP). Consistent with inhibition of QS and TFP expression, we show that auranofin attenuates biofilm maturation, and when used in combination with colistin, displays strong synergy in eradicating P. aeruginosa biofilms. Auranofin may have immediate applications as an anti-virulence drug against P. aeruginosa infections.

Prevention of healthcare associated infections

2019 ◽  
pp. 233-304 ◽  
Author(s):  
Nizam Damani
Keyword(s):  
Prevention And Control ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Central Line ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

This chapter provides the most up-to-date advice on infection prevention and control (IPC) of the four most common healthcare-associated infections (HAIs). These are: surgical site infections; infection associated with peripheral IV line/cannula and central line-associated bloodstream infections (CLABSIs); catheter-associated urinary tract infections (CAUTI); and hospital-acquired and ventilator-acquired pneumonias (VAP). The chapter examines and summarizes various key elements and discusses implementation of HAI care bundles and high impact interventions which are necessary to reduce these infections.

scholarly journals Molecular Characteristics and Antimicrobial Susceptibility Profile of Pseudomonas aeruginosa isolated from patients attending Healthcare Facilities in Mthatha, South Africa

2020 ◽  
Author(s):  
Mojisola C. Hosu ◽  
Sandeep D. Vasaikar ◽  
Grace E. Okuthe ◽  
teke apalata
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Resistance Mechanisms ◽  
High Rate ◽  
Infection Prevention And Control ◽  
Molecular Characteristics ◽  
Mortality And Morbidity ◽  
Resistance Patterns

Abstract Background Pseudomonas aeruginosa is a common pathogen causing healthcare-associated infections most especially in critically ill and immunocompromised patients. This pathogen poses a public health threat due to its innate resistance to many antimicrobial agents and its ability to acquire new resistance mechanisms under pressure. Infections with Extended spectrum β-lactamases (ESBL)-producing isolates result into outbreaks that lead to serious antibiotic management concerns with higher mortality and morbidity and significant economic causatives. In this study, we evaluated the antimicrobial resistance patterns and characterized genetically the ESBLs and Metallo- β-lactamases (MBL) produced by this pathogen. Methods Isolates of P. aeruginosa cultured from patients who attended Nelson Mandela Academic Hospital and other clinics in the four district municipalities of the Eastern Cape between August 2017 and May 2019 were identified; and their antibiotic resistance patterns were tested against amikacin, aztreonam, cefepime, ceftazidime, ciprofloxacin, doripenem, gentamicin, imipenem, levofloxacin, meropenem, piperacillin, piperacillin/tazobactam and tobramycin using the bioMérieux VITEK® 2 and confirmed by Beckman autoSCAN-4 System. Real-time PCR was done using Roche Light Cycler 2.0 to detect the presence of ESBLs; blaSHV, blaTEM and blaCTX-M genes; and MBLs; blaIMP, blaVIM. Results High antibiotic resistance in decreasing order was observed in piperacillin (64.2%), aztreonam (57.8%), cefepime (51.5%), ceftazidime (51.0%), piperacillin/tazobactam (50.5%), and imipenem (46.6%). A total of 75 (36.8%) multidrug resistant (MDR) isolates were observed of the total pool of isolates. The blaTEM, blaSHV and blaCTX-M was detected in 79.3%, 69.5% and 31.7% isolates (n=82), respectively. The blaIMP was detected in 1.25% while no blaVIM was detected in any of the isolates tested. Conclusions The study showed a high rate of MDR P. aeruginosa in our setting. The vast majority of these resistant isolates carried blaTEM and blaSHV genes. Continuous monitoring of antimicrobial resistance and strict compliance towards infection prevention and control practices are the best defence against spread of MDR P. aeruginosa.

Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

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