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PubMed1985

[Significance and problems of pseudomonas infection in ENT medicine].

Pseudomonas aeruginosa is frequently cultured in chronic otitis media, in external otitis, and from infected radical mastoid cavities. Necrotizing external otitis is a typical infection caused by Pseudomonas aeruginosa. Perichondritis of the external ear is sometimes due to a Pseudomonas aeruginosa infection. Some cases of chronic sinusitis and wound infections in patients with tracheostomy are caused by this organism. Antiseptic agents or astringents should be used for local treatment of Pseudomonas infected ears. If these fail local treatment with azlocillin for several days is a good alternative. Systemic antibiotic therapy is also available for Pseudomonas aeruginosa infections.

Anti-Bacterial Agents↗
PubMed1982

[Clinical application of cefsulodin in gravely ill children with Pseudomonas infection].

Our investigation of cefsulodin in pediatric Pseudomonas infect ion produced the following results. 1. Cefsulodin (CFS) was administered intravenously by one shot or drip infusion in 3 patients with Pseudomonas infections. These diseases consisted of pneumonia with IgA deficiency, ALL with opportunistic infection, UTI with paraplegia due to spina bifida. CFS was effective in all cases. 2. Transient eosinophilia was observed in 1 case. But other side effect was not noted in any cases.

Adolescent↗
PubMed1975

Inhibition of supraeschar and subeschar Pseudomonas infection by silver sulfadiazine dry foam.

The results of an in vivo evaluation of silver sulfadiazine dry foam are described. Using burned guinea pigs infected with Pseudomonas aeruginosa, silver sulfadiazine was applied every 12hr as the dry foam or ointment. After 72 hr of therapy with the medicated dry foam, only one of the 15 burns remained infected while seven of the 15 burns remained positive for Pseudomonas after treatment with the corresponding medicated ointment (p less than 0.05 greater than 0.01). It is suggested that the medicated dry foam provided significantly greater activity in treating a supraeschar burn wound infection of recent onset. In addition, a modified crossover study demonstrated that both the medicated dry foam and ointment are less effective in treating subeschar burn wound infections.

Animals↗
PubMed1985

Acute interstitial nephritis associated with mezlocillin, nafcillin, and gentamicin treatment for Pseudomonas infection.

Two patients developed acute interstitial nephritis (AIN) following treatment with mezlocillin sodium. Diagnosis was made by renal biopsy. Gallium 67 citrate scanning was abnormal in both. All patients were receiving multiple-drug therapy, but AIN has either not been described with the other drugs, or the temporal relationship between the AIN and termination of other drug therapy makes a causative relationship unlikely. All were infected with Pseudomonas aeruginosa. A role for the infecting organism or drug synergism in contributing to the renal disease cannot be excluded.

Acute Disease↗
PubMed1993

Middle ear susceptibility to Pseudomonas infection during acute otitis media.

Pneumococcal otitis media was induced bilaterally, and Pseudomonas was inoculated unilaterally into the middle ears of 36 chinchillas to study the pathogenesis of chronic suppurative otitis media. Half of the animals were treated with penicillin prior to Pseudomonas inoculation (day 7, late Pseudomonas), and half were inoculated with Pseudomonas before penicillin treatment (day 3, early Pseudomonas). A third group of 18 chinchillas received unilateral Pseudomonas inoculation without pneumococcus or penicillin (control). Animals with early Pseudomonas were significantly less susceptible to Pseudomonas infection in the Pseudomonas-inoculated ear than animals with late Pseudomonas and controls. Susceptibility to Pseudomonas infection in the contralateral ears, which were not inoculated with Pseudomonas, was significantly lower in early Pseudomonas and control animals than in late Pseudomonas animals. Increased susceptibility in the late Pseudomonas group might have been due to altered nasopharyngeal microflora or persisting eustachian tube dysfunction--factors that may be important in the pathogenesis of chronic suppurative otitis media in humans.

Acute Disease↗
PubMedDate not supplied

Short-term dietary protein manipulation does not affect survival from intraperitoneal pseudomonas infection in mice.

Manipulation of dietary protein has a variable effect on immune function and outcome from infections. In this study we investigated the role of different sources of protein at different levels on the susceptibility of mice to infection with Pseudomonas aeruginosa. CF1 mice were pair-fed diets with 5%, 20%, and 40% protein by weight. At the end of two weeks feeding of the experimental diets, mice were challenged with Ps. aeruginosa intraperitoneally and mortality was recorded over one week. No significant differences in survival among groups fed different levels of protein were seen. Similarly, type of protein used did not affect outcome. We conclude that overall two-week manipulation of dietary protein did not significantly affect outcome from infection in this model.

Animals↗
PubMed1990

The effect of dietary fatty acids on response to Pseudomonas infection in burned mice.

Since fatty acids influence prostaglandin synthesis, and since both fatty acids and prostaglandins modulate immune function, we investigated the hypothesis that manipulation of dietary fats would affect survival after infection in a murine burn model. Mice were fed for 2 to 3 weeks with diets containing different types and amounts of fat. They were then subjected to a 20% flame burn and infected with Pseudomonas aeruginosa. Survival in the group fed 40% of total calories as fish oil had significantly higher mortality than those fed safflower oil. This difference was not noted at lower fat levels. Similar groups of animals were sacrificed the day after injection. Splenic macrophage production of PGE2 was significantly lower in the fish-oil group, but production of LTB4 and TXB2 were not affected. In vitro tests of T- and B-cell function were not different amongst groups. We conclude that manipulation of dietary fats can alter outcome in this murine model of infection after thermal injury.

Animals↗
PubMed2002

Parental fears of Pseudomonas infection and measures to prevent its acquisition.

BACKGROUND AND AIM OF THE STUDY: Chronic infection with Pseudomonas aeruginosa (PA) is associated with accelerated worsening of lung disease in patients with cystic fibrosis (CF). Fears of PA are widespread among parents of CF children, and many parents take precautions at home to prevent acquisition of the bacterium from the environment. The present study was undertaken to describe the type and intensity of these activities. METHODS: Parents of 21 CF children (7 without prior PA infection, 10 with intermittent and 4 with chronic PA infection) were investigated using semistructured interviews. These were analyzed descriptively and with respect to predominant themes. Additionally, a German personality test was used to evaluate the influence of psychological factors. RESULTS: The clinical impression of widespread parental anxieties of PA infection was confirmed. Misunderstandings concerning PA infections were related to a simplistic concept of the underlying biological mechanisms. Some parents which we classified as 'bacterium-focussed' thought that each contact with PA would lead to bacterial infection. These parents used a large variety of measures, which concerned both domiciliary and outdoor surroundings and activities. At the other end of the spectrum were parents which we classified as 'child-focussed' who mostly supported (and relied on) the child's defense mechanism instead of hygienic measures. CONCLUSIONS: Recommendations by physicians on how to prevent PA acquisition from the environment should take into account possible non-intended side effects, since some parents will exaggerate daily precautions to the detriment of the child's (and the parent's) quality of life.

Activities of Daily Living↗
PubMed2006

Impact of IL-10 on diaphragmatic cytokine expression and contractility during Pseudomonas Infection.

Severe weakness of the respiratory muscles, with attendant respiratory failure and death, has been documented in sepsis. In this study, we show that during murine pulmonary infection with Pseudomonas aeruginosa, multiple proinflammatory genes are up-regulated not only within the lungs, but also within the diaphragm. Significant induction of TNF-alpha, IL-1alpha, IL-1beta, IL-6, and IL-18 gene expression occurred within the diaphragm in a bacterial dose-dependent manner. We determined whether the anti-inflammatory cytokine IL-10 could blunt proinflammatory gene expression within the diaphragm under these conditions. The IL-10 receptor was found to be expressed by the diaphragm in vivo as well as in primary diaphragmatic muscle cell cultures. Transduction of myoblasts with an adenoviral vector (Ad-IL-10) induced strong IL-10 expression, and intramuscular injection of the same vector in vivo produced significant increases in IL-10 serum levels. Ad-IL-10 treatment of mice infected with P. aeruginosa significantly inhibited the induction of proinflammatory cytokines within the diaphragm, but not in the infected lungs. Ad-IL-10 treatment also led to greatly improved diaphragmatic force production in infected mice. These results suggest that pulmonary infection triggers proinflammatory gene expression by the diaphragm along with diaphragmatic weakness. Shifting the balance between pro- and anti-inflammatory mediators in favor of the latter by IL-10 gene delivery was able to restore normal diaphragmatic force-generating capacity under these conditions, suggesting a possible avenue for therapeutic intervention.

Animals↗
PubMed1986

Ceftazidime in patients with severe Pseudomonas infections.

Forty patients suffering from severe Pseudomonas infections (13 urinary tract infections, 8 of which complicated, 16 cases of pneumonia, 3 cases of sepsis, 1 case of sepsis with osteomyelitis, 2 cases of osteomyelitis, 1 case of ophthalmitis, and 4 cases of peritonitis) were treated with ceftazidime (1-6 g/die). Most cases presented with severe underlying conditions associated with, or predisposing to, infection (surgical intervention, neoplasia, immunodepression, etc.). Both microbiological results (38 out of 43 strains eradicated) and clinical outcome (28 infections cured, 10 improved, and only 2 unchanged) proved highly satisfactory. The authors advocate the empirical use of ceftazidime as first-line single-drug therapy in severe hospital acquired infections in high-risk patients.

Adolescent↗
PubMed2005

Chronic Pseudomonas infections of cochlear implants.

OBJECTIVE: To discuss chronic, refractory Pseudomonas infections of cochlear implants and their management. DESIGN: Retrospective case series. SETTING: Two university-based cochlear implant programs. PATIENTS: Twenty-eight-year-old (Case 1) and 4-year-old (Case 2), different devices. INTERVENTIONS: Medical and surgical management. MAIN OUTCOME MEASURES: Clinical course. RESULTS: Both patients had delayed presentations, 4 months and 3 years postimplantation, respectively, with fluctuating scalp edema and pain resistant to multiple courses of oral antibiotics. Infections began as localized granulation and progressed to complete encasement of both devices with rubbery, poorly vascularized tissue. In each case, two different strains of multiresistant Pseudomonas aeruginosa were cultured. Infections progressed despite local debridement and targeted antipseudomonal antibiotic coverage, and sensitive organisms continued to appear in cultures of refractory granulation tissue. Both patients underwent partial explantation, with the electrode array left in the cochlea, then received 2 to 3 more months of further medical therapy and observation and then were reimplanted successfully with new devices. Both have shown excellent performance and no sign of recurrent infection. CONCLUSIONS: Infections of cochlear implants are uncommon, and cases of successful conservative management without device explantation have been reported. However, our experience and the implanted device literature suggest that chronic Pseudomonas infections may represent a distinct clinical entity, likely to fail protracted therapy and ultimately require device removal. Fortunately, successful reimplantation is possible.

Adult↗
PubMed1988

[Clinico-morphological manifestations of Pseudomonas infection].

Various aspects of Pseudomonas aeruginosa infection are covered in the review based on 48 topical Soviet and international publications. Pseudomonosis, caused by opportunistic gram-negative bacteria, is related to human infections often acquired in hospitals and occurs at many sites, the principal ones being respiratory and alimentary tracts. There are cases of severe sepsis. Morphologic signs presenting with alterative changes involve marked circulatory disorders about the necrotic tissue and torpid inflammation, are similar in children and adults. Typical are numerous bacterial colonies at the site of inflammation most pronounced at necrotic foci.

Adult↗
PubMed1980

Characteristics of a new bacteriophage, Psp231a, infecting Pseudomonas phaseolicola HB10Y.

Bacteriophage Psp231a infects Pseudomonas phaseolicola, strain HB10Y, which is the host cell for the enveloped bacteriophage phi 6. This paper describes the biophysical characteristics of Psp231a and the physical properties of its nucleic acid. In electron micrographs the virion appears as an icosahedral structure, approximately 55 nm in diameter, with a short tail. The virion density is 1.48 g/cm3 in CsCl, and the sedimentation coefficient is approximately 407S. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed the presence of 12 polypeptides ranging in molecular weight from 5,000 to 117,000. The nucleic acid of Psp231a is linear, double-stranded DNA of molecular weight 28 X 10(6). Its density in CsCl is 1.716 g/cm3, and its sedimentation coefficient in 3 M CsCl is 20.0S, corresponding to an S020,W of 34S.

Bacteriophages↗
PubMed1989

Netilmicin sulfate as single-agent therapy for Pseudomonas infections.

In a prospective multicenter clinical trial, 69 patients with Pseudomonas infections were treated with netilmicin sulfate as the only antipseudomonal antibiotic. Clinical resolution or improvement was observed for 81% of the infections, whereas 19% were considered treatment failures. The bacteriologic response, based on follow-up culture results, showed elimination of Pseudomonas from 62% of the infection sites, with persistence in 30%. All isolates were susceptible by disk susceptibility testing (zone greater than or equal to 15 mm), and by microdilution testing in unsupplemented broth. The majority of isolates, however, were resistant in cation supplemented media. The clinical failures could be accounted for by factors other than netilmicin failure. In conclusion, netilmicin appeared effective as treatment for netilmicin-susceptible Pseudomonas infections in nonneutropenic adults. A low incidence of nephrotoxicity (12%) occurred despite careful monitoring of serum levels.

Adult↗
PubMed2004

Pseudomonas infections in the thermally injured patient.

Pseudomonas aeruginosa, remains a serious cause of infection and septic mortality in burn patients, particularly when nosocomially acquired. A prototypic burn patient who developed serious nosocomially acquired Pseudomonas infection is described as an index case which initiated investigations and measures taken to identify the source of the infection. The effect of changes in wound care to avoid further nosocomial infections was measured to provide data on outcome and cost of care. The bacteriology of Pseudomonas is reviewed to increase the burn care providers understanding of the behaviour of this very common and serious pathogen in the burn care setting, before reviewing the approach to detection of the organism and treatment both medically and surgically. After controlling the nosocomial spread of Pseudomonas in our burn unit, we investigated the morbidity and mortality associated with nosocomial infection with an aminoglycoside resistant Pseudomonas and the associated costs compared to a group of case-matched control patients with similar severity of burn injury, that did not acquire resistant Pseudomonas during hospitalization at our institution. We found a significant increase in the mortality rate in the Pseudomonas group compared to controls. The morbidity in terms of length of stay, ventilator days, number of surgical procedures, and the amount of blood products used were all significantly higher in the Pseudomonas group compared to controls. Costs associated with antibiotic requirements were also significantly higher in the Pseudomonas group. Despite this increased resource consumption necessary to treat Pseudomonas infections, these efforts did not prevent significantly higher mortality rates when compared to control patients who avoided infection with the resistant organism. Thus, in addition to the specific measures required to identify and treat nosocomial Pseudomonas infections in burn patients, prevention of infection through modification of treatment protocols together with continuous infection control measures to afford early identification and eradication of nosocomial Pseudomonas infection are critical for cost-effective, successful burn care.

Adult↗
PubMed1991

Treatment of Pseudomonas infections in peritoneal dialysis patients.

Pseudomonas species infections in the peritoneal dialysis population consist primarily of peritonitis or exit site infections. These organisms have traditionally proven difficult to eradicate, and the standard antibiotic regimen has carried the potential for nephrotoxicity. At our institution, all peritoneal dialysis patients with Pseudomonas exit site infections or peritonitis were treated with an antibiotic combination of intraperitoneal ceftazidime and oral ciprofloxacin. Treatment duration was dependent upon the site of infection. Recurrent exit site infections were treated with a repeated course of the antibiotics, and with surgical debridement and subsequent shaving of the external cuff of double-cuffed catheters. We saw a total of 11 Pseudomonas aeruginosa exit site infections in 7 patients (4 recurrent). Patients with recurrent infections were subsequently cured with the regimen as outlined above. Of 7 patients with Pseudomonas species peritonitis (aeruginosa, fluorescens, stutszeri, and maltophilia), 5 were cured with the initial antibiotic regimen. The 2 failures were both infected with Pseudomonas maltophilia, which is consistent with observed organism sensitivity data. The combination of ceftazidime and ciprofloxacin with the option for surgical debridement of the external cuff (in exit site infections) appears effective in the treatment of Pseudomonas species infections in the peritoneal dialysis population. Sensitivity data should be used to adjust the antibiotic regimen when appropriate.

Ceftazidime↗