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Micro - Overview of Enteric Gram -ve Bacilli (iii) (Pseudomonas (HAIs…
Micro - Overview of Enteric Gram -ve Bacilli (iii)
Pseudomonas
P aeruginosa = most important
normal gut flora - also in soil, plants, moist environments (sink, drains, water)
MDR
pili, flagella, polysacc capsule, pyocyanin (impairs cilia), LPS
community infections
wound infections in immunocompromised
chronic otitis externa (esp in swimmers + diabetics)
HAIs
BSIs via burns
necrotising VAP
chronic infections in CF/bronchiectasis patients
wound infections (DM foot ulcer)
UTI (esp with urinary catheter)
eye infections (esp with contact lenses + trauma)
mucoid non-lactose fermenter, oxidase +ve, strict aerobe
produces a variety of pigments
pyocyanin = blue
pyorubin = red
pyoverdin (aka fluorescein) = green
Tx
limited, intrinisically resistant to many bacteria
piptazobactam
3GC - ceftazidime
quinolone - ciprofloxacin
aminoglycoside - gentamycin
carbapenems (RESERVED)
Burkholderia
B Cepacia
major cause of opportunistic lung infection in CF patients
easily transmitted by social contact
MDR
Cepacia syndrome
acute fatal necrotising pneumonia +/- BSI
B Pseudomallei
in SE Asia
causes melioidosis (multiple lung abscesses + BSI)
B Mallei
from horses / inhalation of organism
causes glanders (skin ulcer, may lead to sepsis)