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Emergence of Antimicrobial Resistance among Pseudomonas aeruginosa: Implications for Therapy

Joseph P Lynch1, George G Zhanel2, Nina M Clark3

  • 1Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California.

Seminars in Respiratory and Critical Care Medicine
|June 5, 2017
PubMed

Insights

Pseudomonas aeruginosa (PA) causes severe hospital infections, especially in vulnerable patients. Rising antimicrobial resistance makes treating PA difficult, increasing mortality risks.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Pseudomonas aeruginosa (PA) is a Gram-negative bacillus frequently causing nosocomial infections in critically ill patients.
  • PA infections occur in ventilator-associated pneumonia (VAP), bloodstream, urinary tract, and wound infections, posing significant challenges.
  • Intrinsic and acquired antimicrobial resistance complicates treatment, leading to high mortality rates, particularly for VAP and bacteremia.

Purpose of the Study:

  • To review the emergence and global escalation of antimicrobial resistance in Pseudomonas aeruginosa.
  • To discuss current and future therapeutic strategies for managing PA infections.

Main Methods:

  • Literature review focusing on antimicrobial resistance trends in Pseudomonas aeruginosa.
  • Analysis of treatment approaches for pseudomonal infections, including empirical and definitive therapies.

Main Results:

  • Antimicrobial resistance in PA has significantly increased globally over the past three decades.
  • Multidrug-resistant epidemic clones of PA have disseminated internationally.
  • High mortality rates (>35%) are associated with pseudomonal VAP and bacteremias, with ongoing therapeutic controversies.

Conclusions:

  • The escalating antimicrobial resistance of Pseudomonas aeruginosa necessitates urgent attention and revised therapeutic strategies.
  • Effective management of PA infections requires a comprehensive approach addressing both resistance patterns and treatment options.

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