Pseudomonas aeruginosa as a Cause of Nosocomial Infections

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.

Chemotherapy and Mechanisms of Action of Antimicrobial Agent

Pseudomonas aeruginosa is a widespread opportunistic pathogen that causes bloodstream, urinary tract, burn wounds infections and is one of the largest pathogens that infect cystic fibrosis patients’ airways and can be life-threatening for P. aeruginosa infections. In addition, P. aeruginosa remains one of the most significant and difficult nosocomial pathogens to handle. Increasingly, multi-drug resistance (MDR) strains are identified and the option of therapy is often very limited in these cases, particularly when searching for antimicrobial combinations to treat serious infections. The fact that no new antimicrobial agents are active against the MDR strains of P. aeruginosa is an additional matter of concern. In recent decades, bacterial drug resistance has increased, but the rate of discovery of new antibiotics has decreased steadily. The fight for new, powerful antibacterial agents has therefore become a top priority. This chapter illustrates and explores the current state of several innovative therapeutic methods that can be further discussed in clinical practice in the treatment of P. aeruginosa infections.