Pseudomonas aeruginosa: Difference between revisions

Revision as of 14:20, 8 October 2020

Broad intrinsic and acquired antibiotic resistance1
Membrane impermeability
- Decreased or absent OprD porin: resistance to carbapenems (imipenem and meropenem)
- Membrane changes: resistance to polymixins (colistin)
- Reduced aminoglycoside transport: resistance to aminoglycosides
Efflux pumps
- MexAB-OprM: resistance to fluoroquinolones and all β-lactams except imipenem
- MexCD-OprJ: resistance to fluoroquinolones and most β-lactams (cefoperazone, cefpirome, cefepime, meropenem) but not imipenem
- MexEF-OprN: resistance to fluoroquinolones and all β-lactams
- MexXY-OprM: resistance to fluoroquinolones, tetracyclines including tigecycline, most β-lactams (but not imipenem or ceftazidime), and aminoglycosides
β-lactamases
- Derepressed AmpC β-lactamase: resistance to penicillins and cephalosporins (except ceftolozane)
- Acquired carbapenemases such as NDM-1: resistance to essentially all β-lactams
Aminoglycoside-modifying enzymes: resistance to aminoglycosides
Target site mutations
- Topoisomerase II (gyrA) or IV (parC) point mutations: resistance to fluoroquinolones

Loves moist and wet environments
Causes healthcare-associated infections
- UTI, SSI, bacteremia, HAP, VAP
- Especially common in cystic fibrosis

Refer to antipseudomonal antibiotics for specific treatment options
Double coverage (ß-lactam + non-ß-lactam) in cases of severe infection in order to ensure activity against the infection

^ D. M. Livermore. Multiple Mechanisms of Antimicrobial Resistance in Pseudomonas aeruginosa: Our Worst Nightmare?. Clinical Infectious Diseases. 2002;34(5):634-640. doi:10.1086/338782.

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 ===Microbiology===
-*Oxidase [[Oxidase::positive]], non-fermenting [[Stain::Gram-negative]] [[Cellular shape::bacillus]]
+*Oxidase [[Oxidase::positive]], non-fermenting [[Stain::Gram-negative]] [[Shape::bacillus]]
 ===Mechanisms of Resistance===