scholarly journals Pseudomonas aeruginosa as a Cause of Nosocomial Infections

2021 ◽  
Author(s):  
Silvia Labovská
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Nosocomial Infections ◽  
Significant Risk ◽  
Lung Ventilation ◽  
Significant Risk Factor ◽  
Hemodynamic Instability ◽  
Multidrug Resistant ◽  
Wound Infections ◽  
Patient Demographics ◽  
Sporadic Cases

Pseudomonas aeruginosa, as a gram-negative aerobic rod, is still one of the most resistant agents of nosocomial infections. It is used for the development of respiratory, urinary and wound infections. It causes bacteremia, especially in patients who are hospitalized for anesthesiology and resuscitation department or ICU, who often have respiratory insufficiency and hemodynamic instability and require artificial lung ventilation. Mechanical ventilation itself is a significant risk factor for the development of pseudomonad pneumonia. Pseudomonas aeruginosa has enzymes that are encoded on both chromosomes and plasmids, often in combination with other mechanisms of resistance, such as reducing the permeability of the outer or cytoplasmic membrane. Due to carbapenemases, Pseudomonas aeruginosa loses sensitivity to carbapenem and becomes resistant to this antibiotic. It also becomes resistant to aminoglycosides, cephalosporins and ureidopenicillins. It is also resistant to Quaternary disinfectants. The reservoir of pseudomonas nosocomial infection is hospital water, taps, shower roses, swimming pools, healing waters and others. The intervention of anti-epidemic measures in the case of infections caused by pseudomonad strains has not yet reached such sophistication as in the case of MRSA for time, personnel and economic reasons. In the absence of an epidemic, intervention in sporadic cases consists of informing nursing staff of the occurrence of a multidrug-resistant agent, including providing all patient demographics and relieving careful adherence to the barrier treatment, cleansing, disinfection and isolation regimen.

scholarly journals Carbapenemases: Transforming Acinetobacter baumannii into a Yet More Dangerous Menace

Biomolecules ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 720 ◽  
Author(s):  
Maria Soledad Ramirez ◽  
Robert A. Bonomo ◽  
Marcelo E. Tolmasky
Keyword(s):  
Acinetobacter Baumannii ◽  
Nosocomial Infections ◽  
Acquired Resistance ◽  
Clinical Manifestations ◽  
High Capacity ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Wound Infections ◽  
Extensively Drug Resistant

Acinetobacter baumannii is a common cause of serious nosocomial infections. Although community-acquired infections are observed, the vast majority occur in people with preexisting comorbidities. A. baumannii emerged as a problematic pathogen in the 1980s when an increase in virulence, difficulty in treatment due to drug resistance, and opportunities for infection turned it into one of the most important threats to human health. Some of the clinical manifestations of A. baumannii nosocomial infection are pneumonia; bloodstream infections; lower respiratory tract, urinary tract, and wound infections; burn infections; skin and soft tissue infections (including necrotizing fasciitis); meningitis; osteomyelitis; and endocarditis. A. baumannii has an extraordinary genetic plasticity that results in a high capacity to acquire antimicrobial resistance traits. In particular, acquisition of resistance to carbapenems, which are among the antimicrobials of last resort for treatment of multidrug infections, is increasing among A. baumannii strains compounding the problem of nosocomial infections caused by this pathogen. It is not uncommon to find multidrug-resistant (MDR, resistance to at least three classes of antimicrobials), extensively drug-resistant (XDR, MDR plus resistance to carbapenems), and pan-drug-resistant (PDR, XDR plus resistance to polymyxins) nosocomial isolates that are hard to treat with the currently available drugs. In this article we review the acquired resistance to carbapenems by A. baumannii. We describe the enzymes within the OXA, NDM, VIM, IMP, and KPC groups of carbapenemases and the coding genes found in A. baumannii clinical isolates.

scholarly journals Impact of Multidrug-Resistant Pseudomonas aeruginosa Bacteremia on Patient Outcomes

2010 ◽  
Vol 54 (9) ◽  
pp. 3717-3722 ◽  
Author(s):  
Vincent H. Tam ◽  
Cary A. Rogers ◽  
Kai-Tai Chang ◽  
Jaye S. Weston ◽  
Juan-Pablo Caeiro ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multidrug Resistance ◽  
Patient Outcomes ◽  
Significant Risk ◽  
Empirical Therapy ◽  
Multidrug Resistant ◽  
Classification And Regression Tree ◽  
Apache Ii Score ◽  
Continuous Variables ◽  
The Impact

ABSTRACT Trends of rising rates of resistance in Pseudomonas aeruginosa make selection of appropriate empirical therapy increasingly difficult, but whether multidrug-resistant (MDR) P. aeruginosa is associated with worse clinical outcomes is not well established. The objective of this study was to determine the impact of MDR (resistance to three or more classes of antipseudomonal agents) P. aeruginosa bacteremia on patient outcomes. We performed a retrospective cohort study of adult patients with P. aeruginosa bacteremia from 2005 to 2008. Patients were identified by the microbiology laboratory database, and pertinent clinical data were collected. Logistic regression was used to explore independent risk factors for 30-day mortality. Classification and regression tree analysis was used to determine threshold breakpoints for continuous variables. Kaplan-Meier survival analysis was used to compare time to mortality, after normalization of the patients' underlying risks by propensity scoring. A total of 109 bacteremia episodes were identified; 25 episodes (22.9%) were caused by MDR P. aeruginosa. Patients with MDR P. aeruginosa bacteremia were more likely to receive inappropriate empirical therapy (44.0% and 6.0%, respectively; P < 0.001) and had longer prior hospital stays (32.6 ± 37.3 and 14.4 ± 43.6 days, respectively; P = 0.046). Multivariate regression revealed that 30-day mortality was associated with multidrug resistance (odds ratio [OR], 6.8; 95% confidence interval [CI], 1.9 to 24.0), immunosuppression (OR, 5.0; 95% CI, 1.4 to 17.5), and an APACHE II score of ≥22 (OR, 29.0; 95% CI, 5.0 to 168.2). Time to mortality was also shorter in the MDR cohort (P = 0.011). Multidrug resistance is a significant risk factor for 30-day mortality in patients with P. aeruginosa bacteremia; efforts to curb the spread of MDR P. aeruginosa could be beneficial.

scholarly journals Frequency and Antimicrobial Susceptibility Pattern of Pseudomonas Aeruginosa in Human Pus Samples at Holy Family Hospital Rawalpindi

2021 ◽  
Vol 6 (1) ◽  
pp. 1-8
Author(s):  
Kazmi A
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Nosocomial Infections ◽  
Antibiotic Susceptibility ◽  
Antimicrobial Agents ◽  
Antibiotic Sensitivity ◽  
Recovery Process ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Resistant Strains

Background: Nosocomial infections are great threat for hospitalized patients and Pseudomonas aeruginosa has emerged as one of the most potent nosocomial pathogens along with its diverse mechanisms to counter the various antimicrobial agents such as aminoglycosides, fluoroquinolones, monobactems, third generation cephalosporins, carbapenams and broad- spectrum penicillins. P. aeruginosa is one of the well-known pyogenic bacteria and is 3rd leading cause of pyogenic infections with the variable frequency depending on geographical region and clinical setting. P. aeruginosa is intimately associated with pyogenic nosocomial infections. Objectives: Since multidrug resistant strains of P. aeruginosa have posed serious threats and are frequently implicated in nosocomial infections. Methods: Pus swab were sampled under aseptic conditions and cultured on blood and Muller Hinton agar. Gram reaction, pigment production, Oxidase, indole reaction and citrate test were used to confirm isolate. Antibiotic susceptibility was performed b Kirby Bauer technique. Results compiled by us in this cross sectional study, showed 58 cases of P. aeruginosa out of 289 cases. This included 43% males and 57% females. Majority of the patients were of young age, with mean age 38 years. Antibiotic sensitivity revealed resistance to gentamicin was 50%, amikacin was 64%, ciprofloxacin and Aztronem 66%, Cefaparazone 69%, Tzaocin 71% and meropenem and sulzone was 79%. While Colistin and Ceftazidime were the most effective in 85% and 89% of cases respectively. The multidrug resistant strains of P. aeruginosa infections accounted for 32.76% of total P. aeruginosa infections. This study reveals high prevalence of multidrug resistant organisms at the set of our study. Based on this study, we suggest adopting the strategies to minimize the risk of nosocomial infections to slow down the rapidly growing multidrug resistance. These strategies may include, stricter antiseptic measures, fastening the recovery process and reducing the hospital stay and considering other alternates. Besides this, we would like to suggest the precise use of antibiotic susceptibility facility to reduce the nosocomial infection associated complications.

scholarly journals Hypertonic glucose inhibits growth and attenuates virulence factors of multidrug-resistant Pseudomonas aeruginosa

2020 ◽  
Author(s):  
Tao Chen ◽  
Ye Xu ◽  
Wenya Xu ◽  
Wenli Liao ◽  
Chunquan Xu ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Virulence Factors ◽  
Diabetic Foot ◽  
Biofilm Formation ◽  
Chronic Wound ◽  
Multidrug Resistant ◽  
Wound Infections ◽  
Hypertonic Glucose ◽  
Diabetic Foot Infections ◽  
Chronic Wound Infections

Abstract Background: Pseudomonas aeruginosa is the most common Gram-negative pathogen responsible for chronic wound infections, such as diabetic foot infections, and further exacerbates the treatment options and cost of such conditions. Hypertonic glucose, a commonly used prolotherapy solution, can accelerate the proliferation of granulation tissue and improve microcirculation in wounds. However, the action of hypertonic glucose on bacterial pathogens that infect wounds is unclear. In this study, we investigated the inhibitory effects of hypertonic glucose on multidrug-resistant P. aeruginosa strains isolated from diabetic foot infections. Hypertonic glucose represents a novel approach to control chronic wound infections caused by P. aeruginosa. Results: Four multidrug-resistant P. aeruginosa clinical strains isolated from diabetic foot ulcers from a tertiary hospital in China and the reference P. aeruginosa PAO1 strain were studied. Hypertonic glucose significantly inhibited the growth, biofilm formation, and swimming motility of P. aeruginosa clinical strains and PAO1. Furthermore, hypertonic glucose significantly reduced the production of pyocyanin and elastase virulence factors in P. aeruginosa. The expression of major quorum sensing genes (lasI, lasR, rhlI, and rhlR) in P. aeruginosa were all downregulated in response to hypertonic glucose treatment. In a Galleria mellonella larvae infection model, the administration of hypertonic glucose was shown to increase the survival rates of larvae infected by P. aeruginosa strains (3/5).Conclusions: Hypertonic glucose inhibited the growth, biofilm formation, and swimming motility of P. aeruginosa, as well as reduced the production of virulence factors and quorum sensing gene expression. Further studies that investigate hypertonic glucose therapy should be considered in treating chronic wound infections.

scholarly journals EPIDEMIOLOGY OF INTRA-ABDOMINAL INFECTIONS IN UKRAINE: RESULTS OF A MULTICENTER STUDY (2014-2015)

2019 ◽  
Vol 72 (4) ◽  
pp. 513-518
Author(s):  
Aidyn G. Salmanov ◽  
Anna V. Kolesnik ◽  
Dmytro V. Andriuschenko
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Nosocomial Infections ◽  
Significant Risk ◽  
Local Data ◽  
Common Cause ◽  
Current Prevalence ◽  
Causative Agents ◽  
National Estimates ◽  
Abdominal Infections

Introduction: Intra-abdominal infections are a common cause of morbidity and mortality worldwide. Early clinical diagnosis and appropriate antimicrobial therapy are the cornerstones in the management of all infections. The aim: Aim of our work was to obtain the first national estimates of the current prevalence of intra-abdominal infections and resistance of their causative agents to antibiotics in Ukrainian hospitals. Materials and methods: In total of 1986 patients with microbiologically proven IAI were included in the study. The identification and antimicrobial susceptibility to antibiotics of cultures were determined, using automated microbiology analyzer and Kirby - Bauer antibiotic testing. Results: Among 1986 patients, 1404 (70.7%) community-acquired and 582 (29.3%) nosocomial infections were observed. Death during hospitalization was reported in 4.1% community-acquired cases and 7.7% nosocomial cases. The distribution of the microorganisms differed according to the nosocomial or community origin of the infection but not according to their location. In nosocomial patients were observed with increased proportions of Enterococcus faecalis and Pseudomonas aeruginosa. The carbapenems and amikacin were the most consistently active against Enterobacteriaceae. Against P. aeruginosa, amikacin, imipenem, ceftazidime and ciprofloxacin were the most active agents in community-acquired infections, while imipenem, cefepime and amikacin were the most active agents in nosocomial cases. Conclusions: The significant risk factors defined should be addressed preoperatively to decrease the risk for nosocomial infections. Antibiotics application tactics should be determined in accordance with the local data of resistance to them in each surgical hospital.

scholarly journals Unusual Polymicrobial Wound Infections In Healthy Patient After Cesarean Sectio

2020 ◽  
Vol 12 (1) ◽  
pp. 1
Author(s):  
Henny Tannady Tan ◽  
Irene Maria Elena ◽  
Ade Dharmawan ◽  
Nicolas Layanto
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Surgical Site Infection ◽  
Maternal Obesity ◽  
Multidrug Resistant ◽  
Klebsiella Pneumonia ◽  
Hypertensive Disorder ◽  
Gram Negative Bacteria ◽  
Wound Infections ◽  
Site Infection ◽  
Healthy Patient

Cesarean delivery often complicated by surgical site infection, wound infection and endometritis. No study mention Multidrug Resistant Klebsiella pneumonia and Acinetobacter lwofii were isolated.Here we report a rare case of polymicrobial wound infections in healthy patient after Cesarean Sectio caused by Pseudomonas aeruginosa, Multidrug Resistant Klebsiella pneumonia and Acinetobacter iwofii. A 30-year-old woman at 37 weeks gestation (G1P0A0) presented to our hospital for cesarean sectio due to oligohydroamnios and malpresentation. She came to us on the eleventh post-delivery day with discharge from her surgical wound. Intraoperative cultures revealed Pseudomonas aeruginosa, Multidrug Resistant Klebsiella pneumonia and Acinetobacter lwofii.The greatest contribution to risk for surgical site infection was associated with maternal obesity and hypertensive disorder, but she has no risk factor.The polymicrobial combination of our patient’s is unique from previously described studies, in this case all were Gram negative bacteria (Pseudomonas aeruginosa, Multidrug Resistant Klebsiella pneumonia and Acinetobacter lwofii).

scholarly journals Risk factors for tuberculous empyema in pleural tuberculosis patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Peng Wen ◽  
Min Wei ◽  
Chao Han ◽  
Yu He ◽  
Mao-Shui Wang
Keyword(s):  
Risk Factors ◽  
Protective Factor ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Epidemiological Data ◽  
Significant Risk Factor ◽  
Multidrug Resistant ◽  
Mortality And Morbidity ◽  
Pulmonary Tb ◽  
Pleural Tuberculosis

AbstractTuberculous empyema (TE) is associated with high mortality and morbidity. In the retrospective cohort study, we aimed to find risk factors for TE among pleural tuberculosis (TB) patients. Between July 2011 and September 2015, all culture-confirmed pleural TB patients (474 cases) were enrolled in our study. Empyema was defined as grossly purulent pleural fluid. Demographic and epidemiological data were collected for further analysis. Multivariate logistic regression analysis was used to evaluate risk factors of TE in pleural TB, age–adjusted odds ratio (OR) and 95% confidence interval (CI) were calculated to show the risk. The mean age was 35.7 ± 18.1 years old, males comprised 79.1% of the participants (375 cases). Forty-seven patients (9.9%) were multidrug-resistant TB (MDR-TB), 29 (6.1%) had retreatment TB, 26 (5.5%) had diabetes mellitus. The percentage of empyema patients was 8.9% (42 cases). Multivariate analysis revealed that male (adjusted OR = 4.431, 95% CI: 1.411, 13.919), pleural adenosine deaminase (ADA, >88 U/L) (adjusted OR = 3.367, 95% CI: 1.533, 7.395) and white blood cell (WBC, >9.52 109/L) (adjusted OR = 5.763, 95% CI: 2.473, 13.431) were significant risk factors for empyema in pleural TB, while pulmonary TB (adjusted OR = 0.155, 95% CI: 0.072, 0.336) was the protective factor for the patients. TE remains a serious threat to public health in China. Male sex is a significant risk factor for TE while the presence of pulmonary TB is protective, and high levels of pleural ADA and WBC count could aid in early diagnosis of TE. This finding would help towards reducing the mortality and morbidity associated with TE.

scholarly journals Differential Effects of Levofloxacin and Ciprofloxacin on the Risk for Isolation of Quinolone-Resistant Pseudomonas aeruginosa

2006 ◽  
Vol 50 (6) ◽  
pp. 2192-2196 ◽  
Author(s):  
Keith S. Kaye ◽  
Zeina A. Kanafani ◽  
Ashley E. Dodds ◽  
John J. Engemann ◽  
Stephen G. Weber ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Case Control Study ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Clinical Strain ◽  
Control Group ◽  
Multivariable Analyses ◽  
Control Study

ABSTRACT Due to the greater in vitro activity of ciprofloxacin than that of levofloxacin against Pseudomonas aeruginosa, the likelihood of isolating a clinical strain of quinolone-resistant (QR) P. aeruginosa might be greater after exposure to levofloxacin than ciprofloxacin. We examined the risk of isolating QR P. aeruginosa in association with prior levofloxacin or ciprofloxacin exposure. A case-case-control study was conducted. Two groups of cases, one with nosocomial QR P. aeruginosa infections and one with nosocomial quinolone-susceptible (QS) P. aeruginosa infections, were compared to a control group of hospitalized patients without P. aeruginosa infections. Bivariable and multivariable analyses were used to determine risk factors for isolation of QR P. aeruginosa and QS P. aeruginosa. One hundred seventeen QR P. aeruginosa and 255 QS P. aeruginosa cases were identified, and 739 controls were selected. Exposures to ciprofloxacin were similar among all three groups (8% for controls, 9.4% for QR P. aeruginosa cases, and 7.5% for QS P. aeruginosa cases; P ≥ 0.6). Levofloxacin use was more frequent in the QR P. aeruginosa cases than in the controls (35.9% and 22.1%, respectively; odds ratio [OR] = 2.0; 95% confidence interval [CI] = 1.3 to 3.0) and less frequent in QS P. aeruginosa cases (14.1% of QS P. aeruginosa cases; OR = 0.6; 95% CI = 0.4 to 0.9). In multivariable analysis, levofloxacin, but not ciprofloxacin, was a significant risk factor for isolation of QR P. aeruginosa (OR for levofloxacin = 1.7 [95% CI = 1.0 to 2.9]; OR for ciprofloxacin = 1.2 [95% CI = 0.6 to 2.5]). Levofloxacin was associated with a reduced risk of isolation of QS P. aeruginosa (OR = 0.6; 95% CI = 0.4 to 0.9), whereas ciprofloxacin had no significant effect (OR = 1.0; 95% CI = 0.6 to 1.8). In conclusion, the use of levofloxacin, but not ciprofloxacin, was associated with isolation of QR P. aeruginosa.

scholarly journals Prevalence and Risk Factors of Metallo β-lactamase Producing Pseudomonas aeruginosa and Acinetobacter species in Burns and Surgical Wards in a Tertiary Care Hospital

2012 ◽  
Vol 4 (01) ◽  
pp. 039-042 ◽  
Author(s):  
Simit H Kumar ◽  
Anuradha S De ◽  
Sujata M Baveja ◽  
Madhuri A Gore
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Tertiary Care ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Care Hospital ◽  
Acinetobacter Species ◽  
Carbapenem Resistant

ABSTRACT Introduction: The production of Metallo-β-lactamases (MBLs) is one of the resistance mechanisms of Pseudomonas aeruginosa and Acinetobacter species. There is not much Indian data on the prevalence of MBLs in burns and surgical wards. Materials and Methods: A total of 145 non-duplicate isolates of carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter species, isolated from pus/wound swabs and endotracheal secretions from burns and surgical wards, were tested for MBL production by modified ethylene diamine tetra acetic acid (EDTA) disc synergy and double disc synergy tests. Results: Prevalence of MBLs was 26.9% by both the above tests. All MBL-positive isolates were multidrug resistant. Only 6.06% (2/33) P.aeruginosa and 16.67% (1/06) Acinetobacter species were susceptible to piperacillin-tazobactam and netilmycin, respectively. These patients had multiple risk factors like >8 days hospital stay, catheterization, IV lines, previous antibiotic use, mechanical ventilation, etc. Graft application and surgical intervention were significant risk factors in MBL-positive patients. Overall mortality in MBL-positive patients was 34.21%. Conclusion: Emergence of MBL-producing Pseudomonas aeruginosa and Acinetobacter species in this hospital is alarming, which reflect excessive use of carbapenems and at the same time, pose a therapeutic challenge to clinicians as well as to microbiologists. Therefore, a strict antibiotic policy and implementation of proper infection control practices will go a long way to prevent further spread of MBLs. Detection of MBLs should also become mandatory in all hospitals.

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