Pseudomonas can infect any part of the body including the liver, brain, bones, and sinuses. Infection of these sites and those not mentioned, however, is much less common than the infections listed above. Your doctor will perform a physical examination and ask you about your medical history and recent symptoms.
They may take a sample of pus, blood, or tissue , and send it to a laboratory. The laboratory will then test the sample for the presence of pseudomonas. Pseudomonas infections are treated with antibiotics. Unfortunately, many pseudomonas infections are becoming more difficult to treat. These bacteria have developed the ability to adapt and overcome antibiotics in their environment. This is called antibiotic resistance. The increase in antibiotic resistance has made treating infections much more challenging.
Pseudomonas infections can often develop resistance to multiple types of antibiotics. It can even sometimes develop resistance during the course of treatment. It is important that your doctor selects an effective antibiotic.
A doctor may send a specimen from a patient to a laboratory first for testing in order to be more certain. The laboratory will test the specimen to determine which antibiotic will work best. Severe infections can be fatal if not treated right away. Call your doctor if you have any new symptoms you are concerned about. Prompt treatment with the correct antibiotic will speed up your recovery time. Thoroughly washing hands and cleaning equipment in hospitals can help prevent infection. Outside a hospital, avoiding hot tubs and swimming pools that are poorly cared for can help prevent infections.
You should remove swimming garments and shower with soap after getting out of the water. There are several things you can do to prevent infection if you are recovering from a procedure or receiving a treatment in a hospital:. The CDC provides detailed information on this and other healthcare-associated infections. Additional reporting by Abbi Libers and Carlene Bauer. Pathogen—Host Interactions in Pseudomonas aeruginosa Pneumonia.
June 1, By subscribing you agree to the Terms of Use and Privacy Policy. Health Topics. Health Tools. Reviewed: December 1, Medically Reviewed. Pseudomonas is a group of bacteria that can cause various types of infections. Pseudomonas aeruginosa is the most common disease-causing form of this bacteria, according to the Centers for Disease Control and Prevention CDC. Symptoms of P. A test may also be done to determine which antibiotics will be most effective, according to the Merck Manual.
The mortality rates for P. In the absence of vascular compromise or diabetes mellitus, a 4-week course of antibiotics may be adequate, dating from initiation of therapy or from the last major surgical debridement In chronic osteomyelitis, in which prolonged therapy is needed, oral ciprofloxacin can play a major role as single-agent therapy. This should follow adequate debridement, hardware removal, and a course of 4 to 6 weeks of parenteral therapy 4 , The future usefulness of oral monotherapy will be limited by the extent of emergence of resistant organisms 4 , Treatment involves cleaning and debriding the infected skin and avoiding moisture.
Therapy with diluted acetic acid can suppress P. The patient should be advised to avoid excessive immersion in hot water, even when wearing protective gloves. After washing, the nails should be dried thoroughly, with the use of a hair dryer to keep the nail plate-nail bed space as dry as possible. Trimming of the nail, until the nail reattaches, should be repeated frequently for weeks. Treatment of the underlying fungal infection is indicated. Other treatments include: Clorox diluted two to three times a day to the space to suppress the growth of P.
Combination anti-Pseudomonal antibiotic therapy is necessary. Leukocyte transfusions or colony stimulating factors are often used. Mortality is high, even with aggressive antibiotic therapy and surgical resection.
Initial therapy should consist of parenteral anti-Pseudomonal therapy. Long-term anti-Pseudomonal therapy for example, oral ciprofloxacin may be necessary for cure. Topical agents are frequently used to prevent infection of burn wounds, including silver sulfadiazine and mafenide Sulfanylon. Outbreaks of sulfadiazine-resistant organisms have occurred in burn units with its heavy usage. When topical agents are used prophylactically, there may be a delay in P. Mafemide has superior eschar penetration compared to silver sulfadiazine.
Early and frequent debridement of necrotic tissue and excision of infected burn wounds is probably more important than topical therapy in preventing infection. Bacteriophages have been tried see Adjunctive Therapy section. P atients with overt infection should be treated aggressively with combination IV antibiotics: an aminoglycoside and a beta-lactam. Antibiotic susceptibility testing is critical for antibiotic choice, since nosocomial strains may be multiply resistant. Patients with significant burns have dramatic alterations in pharmacokinetics of most drugs.
The risk in most patients may be under treatment rather than antibiotic toxicity The applicability of once daily dosing of aminoglycosides in burns patients is unknown, but is possibly advantageous.
Individualized pharmacokinetic dosing with monitoring of aminoglycoside serum concentrations is recommended. Prompt removal of infected intravenous catheters or other hardware such as a ventriculoperitoneal shunt or ear piercing, should be performed, whenever possible. In addition incision and drainage of abscesses, as well as debridement of soft tissue should be performed.
Debridement of the bony involvement in a puncture wound of the foot is necessary for resolution of the osteochondritis infection. Bacteriophages have been advocated as a potential topical application of treatment for post-burn P.
A variety of phages are highly specific for P. A potential benefit of phage therapy is the lack of potential toxic effects, as well as diminished cost compared to systemic therapy. Limited clinical studies have been performed on this approach to therapy 1 , with a clear need for further exploration of this therapy Bacteremia due to P.
Risk factors for mortality include severe sepsis, pneumonia, and a delay in starting effective antimicrobial therapy. The choice and timing of antibiotic therapy is particularly crucial. As an example, in one study of episodes of P. The prognosis of P. In a patient with primary or secondary bacteremia, blood cultures should become negative. For urinary tract infection, urine culture should become negative. In a patient with P. The duration of therapy after an initial favorable clinical response is generally empiric.
Bacteremia and urinary tract infections require at least 10 days of therapy. Meningitis should be treated for 21 days, and endocarditis for at least 42 days. T he goal for most therapy is a curative course of antibiotics for P.
Demonstration of sterilization of cultures, resolution of pain, soft tissue swelling, and erythema are all clinical features to follow in patients with P. In cystic fibrosis, a course of systemic antibiotics will reduce the bacterial burden of chronic infection with P. The endpoint for monitoring therapy of P. Persistent endotracheal colonization frequently occurs despite clinical response Currently, duration of therapy of days is suggested for P. However, if clinical criteria were used and ongoing colonization ignored , a duration of 8 days would appear reasonable Interest in a vaccine to prevent infection in susceptible hosts is tantalizing, especially in the care of patients with cystic fibrosis.
At present, no vaccine is commercially available, but development of vaccines against type II secretion system proteins, as well as LPS, is ongoing. In general P. The bacterium is a difficult organism to eradicate from areas that become contaminated, such as operating rooms, hospital rooms, clinics, and medical equipment. In a hospital room occupied by a patient with a known infection from P.
Bars of soap can become contaminated with P. Nosocomial spread of bacteria is frequently by hands, including P. Bacterial hand counts are higher with rings; long fingernails and artificial fingernails are associated with higher gram-negative bacterial hand contamination.
Education of hospital and all medical personnel on proper hand hygiene is vital for successful infection control of P. However, patient to patient transmission of multiply resistant P. In one investigation, three P. Molecular epidemiologic techniques i. A search for a common environmental source should be undertaken. Contact isolation precaution measures should be used as a mode of control of spread of such organisms if clonality is confirmed and no environmental source is found. Such an approach requires the identification of asymptomatic carriers of the organism and then accommodation of such individuals in single rooms or cohorting with other colonized patients.
Restriction of use of anti-Pseudomonal antibiotics should also be considered to reduce selective pressure leading to mutations contributing to multidrug resistance. Cycling of antimicrobial agents used for empiric therapy has been attempted with some success in hospital intensive care units 6 , 94 , 95 , , , , , while more recent studies showed that cycling of antimicrobial agents did not control the emergence of gram-negative antimicrobial resistant organisms.
S team sterilization is the preferred method for preprocessing heat-stable medical devices. However manual cleaning to remove biological material is a necessary first step in reprocessing any medical device.
Disinfection and sterilization protocols do not work effectively on visibly soiled surfaces. The practice of rinsing equipment in tap water after preprocessing may contaminate a device.
Patients with infections with P. Recommendations for good infection control practices for P. Bacteriopharge therapy of Pseudomonas burn wound sepsis. Ann Medit Burn Club ; Pseudomonas aeruginosa flagella activate airway epithelial cells through asialoGM1 and toll-like receptor 2 as well as toll-like receptor 5.
Afessa B, Green B. Chest ; 4 Prolonged oral ciprofloxacin treatment of recalcitrant and severe osteomyelitis [Abstract ]. Ahmad SI. Treatment of post-burns bacterial infections by bacteriophages, specifically ubiquitous Pseudomonas spp.
Med Hypotheses ;58 4 Impact of antibiotic changes in empirical therapy on antimicrobial resistance in intensive care unit-acquired infections. J Hosp Infect ;52 2 Alvarez-Lerma F. Modification of empiric antibiotic treatment in patients with pneumonia acquired in the intensive care unit. Intensive Care Med ;22 5 Delayed presentations of aortic valve endocarditis in patients with thermal injury.
J Trauma ;52 2 Community-acquired pneumonia due to gram-negative bacteria and pseudomonas aeruginosa: incidence, risk, and prognosis. Arch Intern Med ; 16 Microbes Infect ;5 12 Ball P. Emergent resistance to ciprofloxacin amongst Pseudomonas aeruginosa and Staphylococcus aureus: clinical significance and therapeutic approaches.
J Antimicrob Chemother ;26 Suppl F Baltch A, Smith R. Pseudomonas aeruginosa: infections and treatment. Otitis externa infection in Jordan. Clinical and microbiological features. Saudi Med J ;25 9 Development of beta-lactam resistance and increased quinolone MICs during therapy of experimental Pseudomonas aeruginosa endocarditis. Antimicrob Agents Chemother ;32 2 Role of beta-lactamase in in vivo development of ceftazidime resistance in experimental Pseudomonas aeruginosa endocarditis.
Antimicrob Agents Chemother ;31 2 Comparative study of combined cefepime-amikacin versus ceftazidime combined with amikacin in the treatment of nosocomial pneumonias in ventilated patients. Multicenter group study]. Ann Fr Anesth Reanim ;18 2 Macrolides in cystic fibrosis. Chron Respir Dis ;2 2 Pseudomonas aeruginosa infections in the Intensive Care Unit: can the adequacy of empirical beta-lactam antibiotic therapy be improved?
Int J Antimicrob Agents ;30 5 Pseudomonas aeruginosa tolerance to tobramycin, hydrogen peroxide and polymorphonuclear leukocytes is quorum-sensing dependent.
Microbiology ; Pt 2 Bodmann KF. Current guidelines for the treatment of severe pneumonia and sepsis. Chemotherapy ;51 5 An in vitro study of the potency and stability of fortified ophthalmic antibiotic preparations. Am J Ophthalmol ; 6 Boyce JM, Pittet D.
Ophthalmic Pseudomonas infection in infancy. Arch Dis Child Fetal Neonatal. VAP Study Group. Clin Infect Dis ;26 2 In vitro and in vivo influence of adjunct clarithromycin on the treatment of mucoid Pseudomonas aeruginosa. J Antimicrob Chemother ;45 1 In vitro evaluation of the activity of two doses of Levofloxacin alone and in combination with other agents against Pseudomonas aeruginosa.
Diagn Microbiol Infect Dis ;46 2 Diagn Microbiol Infect Dis ;38 1 Microbiology of sputum from patients at cystic fibrosis centers in the United States. Clin Infect Dis ;27 1 Effect of chronic intermittent administration of inhaled tobramycin on respiratory microbial flora in patients with cystic fibrosis.
J Infect Dis ; 5 Canadian CCTG. A randomized trial of diagnostic techniques for ventilator-associated pneumonia. N Engl J Med ; 25 Meropenem administered as a prolonged infusion to treat serious gram-negative central nervous system infections. Pharmacotherapy ;24 6 Emergence of antibiotic-resistant Pseudomonas aeruginosa: comparison of risks associated with different antipseudomonal agents.
Antimicrob Agents Chemother ;43 6 Centers for Disease Control and Prevention. Infection Control Practices Advisory Committee. Pseudomonas aeruginosa infections associated with transrectal ultrasound-guided prostate biopsies--Georgia, Mixed infection in adult bacterial meningitis. Infection ;28 1 Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial.
Jama ; 19 Bacterial meningitis in hemodialyzed patients. J Nephrol ;17 2 Chmelik V, Gutvirth J. Meropenem treatment of post-traumatic meningitis due to Pseudomonas aeruginosa. J Antimicrob Chemother ;32 6 A double-blind, randomized, prospective trial of a topical antiseptic versus a topical antibiotic in the treatment of otorrhoea. Clin Otolaryngol Allied Sci ;15 1 Clinical and Laboratory Standards Institute.
Seventh ed: Approved Standard; Prospective randomized comparison of imipenem monotherapy with imipenem plus netilmicin for treatment of severe infections in nonneutropenic patients. Antimicrob Agents Chemother ;38 6 Committee on Infectious Diseases.
The use of systemic fluoroquinolones. Pediatrics ; 3 Safety and tolerability of bolus intravenous colistin in acute respiratory exacerbations in adults with cystic fibrosis.
Ann Pharmacother ;34 11 Intrathecal amikacin for the treatment of pseudomonal meningitis. Ann Pharmacother ;38 6 Craig W, Ebert S. Antimicrobial therapy in Pseudomonas aeruginosa infections. Hot tub-associated necrotizing pneumonia due to Pseudomonas aeruginosa.
Clin Infect Dis ;36 3 :e Ventilator-associated pneumonia due to Pseudomonas aeruginosa. Molecular epidemiology in a cluster of cases of postoperative Pseudomonas aeruginosa endophthalmitis. Cystic Fibrosis Foundation. Seventh ed. Bethesda, MD: Approved Standard; Oral ciprofloxacin treatment of Pseudomonas aeruginosa osteomyelitis.
Antimicrob Agents Chemother ;34 5 Adjuvant hyperbaric oxygen in malignant external otitis. Arch Otolaryngol Head Neck Surg ; 1 Evaluation of pefloxacin, ofloxacin and ciprofloxacin in the treatment of thirty-nine cases of chronic osteomyelitis. Gender differences in cystic fibrosis: Pseudomonas aeruginosa infection. J Clin Epidemiol ;48 8 Inhaled tobramycin in non-cystic fibrosis patients with bronchiectasis and chronic bronchial infection with Pseudomonas aeruginosa.
Ann Pharmacother ;39 1 Etiology of severe pneumonia in the very elderly. Influence of previous exposure to antibiotic therapy on the susceptibility pattern of Pseudomonas aeruginosa bacteremic isolates. Clin Infect Dis ;33 11 The comparison of in the vitro effect of imipenem or meropenem combined with ciprofloxacin or levofloxacin against multidrug-resistant Pseudomonas aeruginosa strains.
Int J Antimicrob Agents ;20 5 In vitro activity of combination therapy with cefepime, piperacillin-tazobactam, or meropenem with ciprofloxacin against multidrug-resistant Pseudomonas aeruginosa strains. Chemotherapy ;49 6 Polymyxin B sulfate and colistin: old antibiotics for emerging multiresistant gram-negative bacteria.
Ann Pharmacother ;33 9 Mortality due to ventilator-associated pneumonia or colonization with Pseudomonas or Acinetobacter species: assessment by quantitative culture of samples obtained by a protected specimen brush. Clin Infect Dis ;23 3 Is bronchoalveolar lavage with quantitative cultures a useful tool for diagnosing ventilator-associated pneumonia?
Crit Care ;11 2 Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia. A randomized trial. Ann Intern Med ; 8 Colistin: the revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections.
Clin Infect Dis ;40 9 Conditions for the emergence of resistance to cefpirome and ceftazidime in experimental endocarditis due to Pseudomonas aeruginosa. J Antimicrob Chemother ;33 3 Pseudomonas aeruginosa: growth in distilled water from hospitals. Science ; Wei Sheng Wu Xue Bao ;40 2 Treatment of severe pneumonia in hospitalized patients: results of a multicenter, randomized, double-blind trial comparing intravenous ciprofloxacin with imipenem-cilastatin.
The Severe Pneumonia Study Group. Antimicrob Agents Chemother ;38 3 Aqueous and vitreous penetration of levofloxacin after oral administration. Ophthalmology ; 12 FitzSimmons S. Meeting of the International B. Vigtoria, BC, Canada: ; Loss of bacterial diversity during antibiotic treatment of intubated patients colonized with Pseudomonas aeruginosa.
J Clin Microbiol ;45 6 Clin Infect Dis ;16 5 Pneumonia due to Pseudomonas aeruginosa: part I: epidemiology, clinical diagnosis, and source. Penetration of ceftazidime into the cerebrospinal fluid of patients with and without evidence of meningeal inflammation. Antimicrob Agents Chemother ;26 1 In vitro antibacterial spectrum of a new broad-spectrum 8-methoxy fluoroquinolone, gatifloxacin. J Antimicrob Chemother ;45 4 Antibacterial spectrum of a novel des-fluoro 6 quinolone, BMS Antimicrob Agents Chemother ;44 12 Chronic osteomyelitis caused by multi-resistant Gram-negative bacteria: evaluation of treatment with newer quinolones after prolonged follow-up.
J Antimicrob Chemother ;39 2 Contemporary assessment of antimicrobial susceptibility testing methods for polymyxin B and colistin: review of available interpretative criteria and quality control guidelines. J Clin Microbiol ;39 1 Ciprofloxacin-resistant Pseudomonas keratitis. Ophthalmology ; 7 Left-sided endocarditis caused by Pseudomonas aeruginosa: successful treatment with meropenem and tobramycin.
Diagn Microbiol Infect Dis ;47 2 Gerald B, Rhamphal R. Pseudomonas aeruginosa. Sixth ed. Philadelphia, PA: Elsevier; Immunomodulatory clarithromycin treatment of experimental sepsis and acute pyelonephritis caused by multidrug-resistant Pseudomonas aeruginosa. Antimicrob Agents Chemother ;48 1 In vitro interaction of colistin and rifampin on multidrug-resistant Pseudomonas aeruginosa.
J Chemother ;15 3 Giamarellou H. Malignant otitis externa: the therapeutic evolution of a lethal infection. J Antimicrob Chemother ;30 6 Antimicrob Agents Chemother ;19 5 Evaluation of combination chemotherapy in a lightly anesthetized animal model of Pseudomonas pneumonia.
Antimicrob Agents Chemother ;31 3 Gordon A, Isaacs D. Late onset neonatal Gram-negative bacillary infection in Australia and New Zealand: Within the current structure, clinicians must optimize aminoglycoside therapy with strategies such as once-daily dosing or using tobramycin instead of gentamicin if MICs are reduced.
For ciprofloxacin, intensive dosing regimens of mg or higher intravenously three times daily have been proposed. Pharmacodynamic considerations are essential to the appropriate management of these serious infections. Figure 1. Figure 2. Each case was then plotted using the mean probability of the respective range.
Patient demographic and infection characteristics for 50 cases of P. Antibiotic pharmacokinetic parameters and pharmacodynamic indices in 38 patients with P. Univariate analysis of risk factors for treatment failure in 38 patients with P. Data presented as No. Bodey, G. Pseudomonas bacteremia.
Retrospective analysis of episodes. Archives of Internal Medicine , —9. Hilf, M. Antibiotic therapy for Pseudomonas aeruginosa bacteremia: outcome correlations in a prospective study of patients. American Journal of Medicine 87 , —6. Carratala, J. Bacteremic pneumonia in neutropenic patients with cancer: causes, empirical antibiotic therapy, and outcome.
Archives of Internal Medicine , — Todeschini, G. Improved prognosis of Pseudomonas aeruginosa bacteremia in consecutive neutropenic patients with hematologic malignancies. International Journal of Infectious Disease 3 , 99 — Vidal, F. Epidemiology and outcome of Pseudomonas aeruginosa bacteremia, with special emphasis on the influence of antibiotic treatment.
Analysis of episodes. Archives of Internal Medicine , —6. Aliaga, L. A clinical index predicting mortality with Pseudomonas aeruginosa bacteraemia.
Journal of Medical Microbiology 51 , — Chen, S. Pseudomonas aeruginosa bacteraemia. Is pancreatobiliary disease a risk factor? Medical Journal of Australia , —7. Bisbe, J. Pseudomonas aeruginosa bacteremia: univariate and multivariate analyses of factors influencing the prognosis in episodes. Reviews in Infectious Disease 10 , — Kuikka, A.
Factors associated with improved outcome of Pseudomonas aeruginosa bacteremia in a Finnish university hospital. Carmeli, Y. Emergence of antibiotic-resistant Pseudomonas aeruginosa : comparison of risks associated with different antipseudomonal agents. Antimicrobial Agents and Chemotherapy 43 , — Harbarth, S. Epidemiology and prognostic determinants of bloodstream infections in surgical intensive care.
Archives of Surgery , —9. Ibrahim, E. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest , — Kollef, M. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients.
Forrest, A. Pharmacodynamics of intravenous ciprofloxacin in seriously ill patients. Antimicrobial Agents and Chemotherapy 37 , — Preston, S. Pharmacodynamics of levofloxacin: a new paradigm for early clinical trials.
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