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At least 271 records · Page 15Linked to original sources
PubMed1987

Pseudomonas infection of the biliary system resulting from use of a contaminated endoscope.

Pseudomonas aeruginosa was present in bile cultures from 10 patients who had undergone previous endoscopic retrograde cholangiopancreatography in 1984. After environmental cultures and review of instrument disinfection, we traced the infections to a single endoscope contaminated with P. aeruginosa, serotype 10. Although the instrument had been cleaned repeatedly with an automatic endoscope cleaning machine, P. aeruginosa survived on residual moisture left in the channels of the endoscope. Contamination ended only after we began to manually suction alcohol through the endoscope before air drying. In 5 of 10 patients, P. aeruginosa caused clinical infections including gangrenous cholecystitis, abscesses, and death. We could identify no factor that distinguished symptomatic from asymptomatic patients. In asymptomatic patients, P. aeruginosa was recovered from gallbladder bile up to 2 mo after endoscopic retrograde cholangiopancreatography. As this P. aeruginosa epidemic was discovered retrospectively because we monitor bile cultures, we advocate this practice as part of endoscopic retrograde cholangiopancreatography procedures.

Bile↗
PubMed2002

Effects of reduced mucus oxygen concentration in airway Pseudomonas infections of cystic fibrosis patients.

Current theories of CF pathogenesis predict different predisposing "local environmental" conditions and sites of bacterial infection within CF airways. Here we show that, in CF patients with established lung disease, Pseudomonas aeruginosa was located within hypoxic mucopurulent masses in airway lumens. In vitro studies revealed that CF-specific increases in epithelial O(2) consumption, linked to increased airway surface liquid (ASL) volume absorption and mucus stasis, generated steep hypoxic gradients within thickened mucus on CF epithelial surfaces prior to infection. Motile P. aeruginosa deposited on CF airway surfaces penetrated into hypoxic mucus zones and responded to this environment with increased alginate production. With P. aeruginosa growth in oxygen restricted environments, local hypoxia was exacerbated and frank anaerobiosis, as detected in vivo, resulted. These studies indicate that novel therapies for CF include removal of hypoxic mucus plaques and antibiotics effective against P. aeruginosa adapted to anaerobic environments.

Adult↗
PubMed1978

Comparison of 5-episisomicin (Sch 22591), gentamicin, sisomicin, and tobramycin in treatment of experimental Pseudomonas infections in mice.

Sch 22591 (5-episisomicin), gentamicin, sisomicin, and tobramycin were compared for their ability to protect mice from lethal intraperitoneal challenge with 12 Pseudomonas strains, all susceptible to each of the aminoglycosides (minimal inhibitory concentrations and minimal bactericidal concentrations were </=6.2 mug/ml). Median 50% protective doses were 5.8, 6.4, 7.7, and 17.8 mg/kg for Sch 22591, tobramycin, sisomicin, and gentamicin, respectively. Those for Sch 22591 were significantly lower than gentamicin in five protection tests and significantly lower than both gentamicin and tobramycin in one test. Microbial analysis of the therapeutic effect indicated that protection from lethality by each of the four aminoglycosides was associated with either a complete eradication or a reduction in the number of challenge bacteria in both the heart blood and peritoneum. In rare instances, challenge isolates exhibiting decreased susceptibility to one or more of the aminoglycosides were recovered from animals. However, this in vivo selection of resistance did not appear related to either the aminoglycoside used in therapy or the outcome of therapy, and resistant isolates were recovered as frequently from untreated animals as from those receiving one of the four aminoglycosides.

Animals↗