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A Delayed Inoculation Model of Chronic Pseudomonas aeruginosa Wound Infection
Published on: February 20, 2020
Pseudomonas aeruginosa Infections in Cancer Patients
Paulina Paprocka1, Bonita Durnaś1, Angelika Mańkowska1
1Department of Microbiology and Immunology, Institute of Medical Science, Collegium Medicum, Jan Kochanowski University, IX Wieków Kielc 19A, 25-317 Kielce, Poland.
Abstract:
Pseudomonas aeruginosa (P. aeruginosa) is one of the most frequent opportunistic microorganisms causing infections in oncological patients, especially those with neutropenia. Through its ability to adapt to difficult environmental conditions and high intrinsic resistance to antibiotics, it successfully adapts and survives in the hospital environment, causing sporadic infections and outbreaks. It produces a variety of virulence factors that damage host cells, evade host immune responses, and permit colonization and infections of hospitalized patients, who usually develop blood stream, respiratory, urinary tract and skin infections. The wide intrinsic and the increasing acquired resistance of P. aeruginosa to antibiotics make the treatment of infections caused by this microorganism a growing challenge. Although novel antibiotics expand the arsenal of antipseudomonal drugs, they do not show activity against all strains, e.g., MBL (metalo-β-lactamase) producers. Moreover, resistance to novel antibiotics has already emerged. Consequently, preventive methods such as limiting the transmission of resistant strains, active surveillance screening for MDR (multidrug-resistant) strains colonization, microbiological diagnostics, antimicrobial stewardship and antibiotic prophylaxis are of particular importance in cancer patients. Unfortunately, surveillance screening in the case of P. aeruginosa is not highly effective, and a fluoroquinolone prophylaxis in the era of increasing resistance to antibiotics is controversial.
Insights
Pseudomonas aeruginosa infections pose a significant threat to cancer patients. Rising antibiotic resistance necessitates enhanced preventive strategies beyond current surveillance and prophylaxis methods.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Oncology
Background:
- * Pseudomonas aeruginosa (P. aeruginosa) is a frequent opportunistic pathogen in cancer patients, particularly those with neutropenia.
- * Its environmental adaptability and intrinsic antibiotic resistance contribute to hospital-acquired infections and outbreaks.
- * P. aeruginosa infections manifest as bloodstream, respiratory, urinary tract, and skin infections, complicating patient care.
Purpose of the Study:
- * To highlight the challenges in treating P. aeruginosa infections in cancer patients due to increasing antibiotic resistance.
- * To emphasize the importance of preventive measures in managing these infections.
- * To discuss the limitations of current surveillance and prophylaxis strategies.
Main Methods:
- * Review of existing literature on P. aeruginosa epidemiology, virulence, and antibiotic resistance in oncological settings.
- * Analysis of treatment challenges posed by multidrug-resistant (MDR) strains, including metallo-β-lactamase (MBL) producers.
- * Evaluation of the effectiveness and controversies surrounding preventive methods like surveillance and antibiotic prophylaxis.
Main Results:
- * P. aeruginosa exhibits significant intrinsic and acquired antibiotic resistance, complicating treatment options.
- * Novel antibiotics are not universally effective, with resistance already emerging.
- * Current surveillance methods for P. aeruginosa colonization are not highly effective.
- * Fluoroquinolone prophylaxis is controversial due to rising resistance.
Conclusions:
- * The increasing antibiotic resistance of P. aeruginosa is a major challenge in cancer patient care.
- * Preventive strategies, including transmission control, diagnostics, and antimicrobial stewardship, are crucial.
- * Enhanced surveillance and reconsidered prophylaxis approaches are needed to combat P. aeruginosa infections in immunocompromised patients.
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