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PubMed1989

Detection of soluble Pseudomonas aeruginosa antigens in bronchial secretions by a coagglutination test.

The coagglutination test was used for the detection of soluble Pseudomonas aeruginosa antigens in 165 bronchial secretions collected from critically ill patients with pulmonary infection. Of 57 cultures positive for Pseudomonas aeruginosa, 41 were positive by the coagglutination test. The test had a specificity of 97%, a sensitivity of 72%, a positive predictive value of 93% and a negative predictive value of 87% when compared with agar culturing. Quantitation of bacterial growth indicated that some Pseudomonas aeruginosa isolates were probably strains colonizing the bronchial tree of intubated patients rather than the etiologic agent of infection. When these specimens were excluded, the sensitivity and negative predictive value were 87% and 94.6%, respectively. The coagglutination test cannot replace isolation methods, but it is a rapid and useful procedure to screen patients suspect for pulmonary infection caused by Pseudomonas aeruginosa, providing a presumptive diagnosis when the result is positive.

Agglutination Tests↗

PubMed1993

Immunoglobulin G antibodies to Pseudomonas aeruginosa lipopolysaccharides and exotoxin A in patients with cystic fibrosis or bacteremia.

IgG antibodies to nine Pseudomonas aeruginosa lipopolysaccharides (LPS) and exotoxin A in sera from 11 patients with bacteremia and 51 patients with cystic fibrosis (CF) were analyzed. The methods used were enzyme immunoassay (EIA) and immunoblotting. Nine of the 11 bacteremic patients were infected with strains expressing an LPS serotype identical to one of the test antigens. In sera from six of these nine patients, antibody homologous to the serotype of the infecting strain was observed. An antibody response to heterologous Pseudomonas aeruginosa LPS antigens was observed in nine patients. Eight of the bacteremic patients mounted an antibody response to exotoxin A. Thirty-five CF patients chronically colonized with Pseudomonas aeruginosa possessed significantly higher levels of antibody to all of the test antigens than 16 patients with intermittent or no colonization (p < 0.001). For exotoxin A and serotype 3 the sensitivity was 91% and 94%, and the specificity 94% and 88% respectively. When the results for exotoxin A and serotype 3 were combined, the sensitivity was 91% while the specificity was 81%. The pronounced antibody response to heterologous LPS antigens, as measured by the EIA and immunoblot, suggests expression of a common antigen determinant. A simplified serological assay utilizing exotoxin A and serotype 3 as test antigens may be useful for detecting Pseudomonas aeruginosa infections in patients with CF and chronic colonization and in bacteremic patients from whom cultures are not available.

Adolescent↗

PubMed1985

Antibiotic resistance of Pseudomonas aeruginosa colonizing a urinary catheter in vitro.

A modified Robbins Device was used to establish coherent biofilms of Pseudomonas aeruginosa on the surface of catheter material in an artificial urine milieu and the ability of an antibiotic to penetrate the biofilm and kill the enclosed bacteria was assessed. The Pseudomonas aeruginosa strain used had been isolated from a patient with urinary tract infection. Although planktonic (floating) cells of the Pseudomonas aeruginosa strain were inhibited by less than 1 mg/l of tobramycin and killed by 50 mg/l, contact with 1,000 mg/l of tobramycin for 12 h failed to kill all the sessile (adherent) bacteria in the biofilms on the surface of the catheter material. Surviving sessile bacteria recovered directly from the exposure to 1,000 mg/l of tobramycin were inhibited by 0.4 mg/l of this agent when tested as dispersed planktonic cells by standard MIC methods. It is suggested that growth within thick adherent biofilms confers upon cells of Pseudomonas aeruginosa a large measure of resistance to aminoglycosides and other antibiotics that may help to explain the frequent failure of antibiotic chemotherapy in catheter-associated urinary tract infections.

Anti-Bacterial Agents↗

PubMed1985

Twenty-five year review of Pseudomonas aeruginosa bacteremia in a burn center.

The incidence of Pseudomonas aeruginosa bacteremia was examined in 5,882 burn patients consecutively admitted over a 25-year period to one burn center. The population examined had an average burn size of 33.8% of the body surface and an average age of 26.3 years. Pseudomonas aeruginosa bacteremia occurred in 540 patients. These patients had an average burn size of 54.2% and average age of 28 years. Mortality was 77%. Bacteremia with other organisms occurred during hospitalization of all but 128 of the 540 patients. Comparison of predicted mortality based on burn size and age to observed mortality showed Pseudomonas aeruginosa bacteremia to be associated with a 28% increase in mortality. Examination of mortality as a function of time showed no significant change over the 25-year period. The incidence of Pseudomonas aeruginosa colonization and infection was examined in 400 recently admitted burn patients. Colonization occurred in 107 and 34 infections were recorded in 27 of the colonized patients.

Adult↗

PubMed1985

Immunotherapeutic potential of monoclonal antibodies against Pseudomonas aeruginosa protein F.

To unambiguously demonstrate the immunotherapeutic potential of outer membrane porin protein F from Pseudomonas aeruginosa, a series of monoclonal antibodies have been isolated and demonstrated to be specific for protein F by Western blotting procedures. The antibodies recognize a surface-exposed antigenic site that is conserved on all Pseudomonas aeruginosa strains tested to date. One of these monoclonal antibodies named MA4-4 resulted in passive protection against subsequent infections by Pseudomonas aeruginosa in two different mouse infection models. In vitro studies using human polymorphonuclear leukocytes suggested that this antibody opsonized Pseudomonas aeruginosa for phagocytosis. The data suggest that immunotherapy based on porin protein F has definite potential for success.

Antibodies, Bacterial↗

PubMed2006

Genotypic characterization and phylogenetic relations of Pseudomonas sp. (Formerly P. stutzeri) OX1.

Pseudomonas sp. OX1, an aromatic compound-degrading bacterium that was tentatively identified by conventional biochemical methods as P. stutzeri, has now been investigated at the molecular level to clarify its taxonomic position. Amplified ribosomal DNA restriction analysis and multiple enzyme restriction fragment length polymorphism (MERFLP) analysis suggested that Pseudomonas sp. OX1 could not be classified as P. stutzeri. Phylogenetic analyses based on 16S rRNA and gyrB genes further confirmed that this strain belongs to the Pseudomonas (sensu stricto) genus, but not to the stutzeri species. The data obtained demonstrated that Pseudomonas sp. OX1 belongs to intrageneric cluster II and is related to the P. fluorescens-P. syringae complex.

Bacterial Typing Techniques↗

PubMed1975

Use of a Pseudomonas Aeruginosa vaccine in pateints with acute leukemia and cystic fibrosis.

A heptavalent lipopolysaccharide Pseudomonas vaccine was evaluated in 22 patients with acute leukemia and 12 patients with cystic fibrosis during an 18 month interval at the Clinical Center of the National Institutes of Health. Of the 34 patients, 32 had an excellent serum hemagglutinating (HA) antibody response to immunization. In comparison to the patients with cystic fibrosis, the patients with leukemia had a smaller HA antibody response, which lasted a shorter period of time, and also experienced greater toxicity from the vaccine. The mixing of adrenal corticosteroids with vaccine greatly decreased side reactions among the patients with leukemia without significantly inhibiting antibody production. Previous antineoplastic chemotherapy had little influence on antibody response in patients with leukemia, with the exception of methortrexate. Vaccinated patients with leukemia had 1 Pseudomonas infection of 14 bacterial or fungal infections, whereas 2 pseudomonas infections of 5 bacterial or fungal infections occurred in a control group of 20 patients with acute leukemia. Of the 12 patients with cystic fibrosis, 4 had a Pseudomonas infection after vaccination.

Adolescent↗

PubMed1991

Prevention of chronic Pseudomonas aeruginosa colonisation in cystic fibrosis by early treatment.

To assess whether chronic pulmonary colonisation with Pseudomonas aeruginosa in cystic fibrosis is preventable, 26 patients who had never received anti-pseudomonas chemotherapy were randomly allocated to groups receiving either no anti-pseudomonas chemotherapy or oral ciprofloxacin and aerosol inhalations of colistin twice daily for 3 weeks, whenever Ps aeruginosa was isolated from routine sputum cultures. During the 27 months of the trial, infection with Ps aeruginosa became chronic in significantly fewer treated than untreated subjects (2 [14%] vs 7 [58%]; p less than 0.05) and there were significantly fewer Ps aeruginosa isolates in routine sputum cultures in the treated group (49/214 [23%] vs 64/158 [41%]; p = 0.0006). Thus, chronic colonisation with Ps aeruginosa can be prevented in cystic fibrosis by early institution of anti-pseudomonas chemotherapy.

Child↗

PubMedDate not supplied

Pseudomonas aeruginosa bacteremia: an analysis of 123 episodes, with particular emphasis on the effect of antibiotic therapy.

OBJECTIVES: To review current experience with Pseudomonas aeruginosa bacteremia and compare outcome of patients treated with single-drug, versus combination therapy. METHODS: The charts of all patients with P. aeruginosa bacteremia between 1990 and 1992 were reviewed, and pertinent demographic, clinical, and bacteriologic data were retrieved. In addition, similar data were collected from a series of patients with P. aeruginosa bacteremia from the literature of the past 20 years. RESULTS: One hundred and twenty-three episodes of P. aeruginosa bacteremia in 121 patients were identified. Most patients were older than 70 years, had at least one underlying condition, and had acquired the infection in the hospital. Attributable mortality was 34%. After exclusion for early mortality and inappropriate therapy, 57 patients remained eligible for comparison of outcome according to therapy protocol. Mortality from infection was equal between the group of 42 patients who received monotherapy and the 15 patients who received combination therapy (14% and 13%, respectively). The literature review revealed eight articles describing 21 to 410 episodes of Pseudomonas bacteremia. The clinical characteristics of these series did not differ significantly from those of the present series. CONCLUSIONS: Incidence, epidemiology, clinical characteristics, and outcome of pseudomonas sepsis did not change significantly over the past 2 decades. Appropriate monotherapy was as effective as combination drug therapy for individuals with pseudomonas bacteremia surviving the first 2 days of infection.

Adolescent↗

PubMed1984

Structural basis for the variation of pH-dependent redox potentials of Pseudomonas cytochromes c-551.

The redox potentials of many c-type cytochromes vary with pH over the physiological pH range. We have investigated the pH dependence of redox potential for the four homologous cytochromes c-551 from Pseudomonas aeruginosa, Pseudomonas stutzeri strain 221, Pseudomonas stutzeri strain 224, and Pseudomonas mendocina . The pH dependence is due to an ionizable group that ionizes with pKox in ferricytochrome c-551 but with a higher pK, pKred , in ferrocytochrome c-551. For P. aeruginosa cytochrome c-551 it has been shown that this ionizable group is one of the heme propionic acid substituents [Moore, G. R., Pettigrew , G. W., Pitt , R. C., & Williams, R. J. P. (1980) Biochim. Biophys. Acta 590, 261-271]but the values of pKox and pKred are significantly lower in this protein than in the other three cytochromes. NMR and chemical modification studies show that for the two P. stutzeri cytochromes c-551 and P. mendocina cytochrome c-551, this propionic acid substituent is again important for the pH dependence of the redox potential. However, a histidine occurring at position 47 in their sequences hydrogen bonds to the propionic acid and thereby raises its pK. In P. aeruginosa cytochrome c-551, His-47 is substituted by Arg-47. Hydrogen-bonding schemes involving His-47 and the propionic acid are proposed.

Bacterial Proteins↗

PubMed1998

Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa isolation from pharyngeal swab cultures among the Japanese elderly at admission to a geriatric hospital.

The isolation rate of Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa from pharyngeal swab cultures in the Japanese elderly was studied at admission to a geriatric hospital which had long-term care units. The subjects were 233 consecutive patients who were admitted to K Hospital in the time period April 1994 to March 1996. The isolation rate of MRSA and of Pseudomonas aeruginosa was 10.3% and 8.2% respectively. The proportions of the patients with severely to moderately limited Activities of Daily Living (ADL) (ADL score = 0-1) (P < 0.01), those with fever (P < 0.01), those with CRP positive (P = 0.04) and those with hypoalbuminemia (serum albumin < 3.5 g/dl) (P < 0.01) were higher in the MRSA positive patients than in the negative patients while the proportion of the patients with fever was higher in the Pseudomonas aeruginosa positive patients than in the negative patients (P < 0.02). In the multiple logistic regression analysis, the limitation of ADL (ADL score 0-1 vs 2-3, OR = 1.54, 95% CI = 1.02-2.33) and fever (with vs without, OR = 1.77, 95% CI = 1.18-2.66) remained as risk factors for the isolation of MRSA while only fever (with vs without, OR = 1.67, 95% CI = 1.11-2.53) remained as a risk factor for the isolation of Pseudomonas aeruginosa.

Activities of Daily Living↗

PubMed1965

THE METABOLISM OF GALACTARATE, D-GLUCARATE AND VARIOUS PENTOSES BY SPECIES OF PSEUDOMONAS.

1. When NAD(+) was present, cell extracts of Pseudomonas (A) grown with d-glucarate or galactarate converted 1mol. of either substrate into 1mol. each of 2-oxoglutarate and carbon dioxide; 70-80% of the gas originated from C-1 of the hexarate. 2. The enzyme system that liberated carbon dioxide from galactarate was inactive in air and was stabilized by galactarate or Fe(2+) ions; the system that acted on d-glucarate was more stable and was stimulated by Mg(2+) ions. 3. When NAD(+) was not added, 2-oxoglutarate semialdehyde accumulated from either substrate. This compound was isolated as its bis-2,4-dinitrophenylhydrazone, and several properties of the derivative were compared with those of the chemically synthesized material. Methods were developed for the determination of 2-oxoglutarate semialdehyde. 4. Synthetic 2-oxoglutarate semialdehyde was converted into 2-oxoglutarate by an enzyme that required NAD(+); the reaction rate with NADP(+) was about one-sixth of that with NAD(+). 5. For extracts of Pseudomonas (A) grown with d-glucarate or galactarate, or for those of Pseudomonas fragi grown with l-arabinose or d-xylose, specific activities of 2-oxoglutarate semialdehyde-NAD oxidoreductase were much higher than for extracts of the organisms grown with (+)-tartrate and d-glucose respectively. 6. Extracts of Pseudomonas fragi grown with l-arabinose or d-xylose converted l-arabonate or d-xylonate into 2-oxoglutarate when NAD(+) was added to reaction mixtures and into 2-oxoglutarate semialdehyde when NAD(+) was omitted.

Acids↗

PubMed2004

[Nosocomial pseudomonas aeruginosa-associated keratitis in soft contact lens wearer].

BACKGROUND: Pseudomonas aeruginosa is the most common cause of bacterial-associated keratitis in soft contact lens wearers, due to wrong use of soft contact lenses. Problems are often severe corneal ulcers and even corneal perforations. We report on a soft contact lens wearer with credibly correct use of soft contact lenses and nosocomial Pseudomonas aeruginosa-associated keratitis. CASE REPORT: A 33-year old woman suffered from corneal ulcer and corneal infiltration with beginning endophthalmitis 2 days after having used of new soft contact lenses. After systemic and local antibiosis and penetrating keratoplasty we could stop endophthalmitis before reaching the vitreous and retina. RESULTS: Histological and microbiological examinations showed a corneal ulcer with severe corneal infection due to Pseudomonas aeruginosa with resistance to mezlocillin and intermediale resistance to gentamicin. After therapy a stable situation with visual acuity of 20/60 was attained. CONCLUSIONS: Previous reports on Pseudomonas aeruginosa-associated keratitis in soft contact lens wearers demonstrate corneal problems due to extended or overnight wear or unsuccessful contact lens cleaning. We present a case of nosocomial corneal infection after soft contact lens wearing and nosocomial infection because of contact with a partner working in an intensive-care unit. Hygienic rules should be strictly followed by patients and staff using soft or hard contact lenses for visual correction or for therapeutic reasons.

Adult↗

PubMed2005

Comparison of ophthalmic gatifloxacin 0.3% and ciprofloxacin 0.3% in healing of corneal ulcers associated with Pseudomonas aeruginosa-induced ulcerative keratitis in rabbits.

OBJECTIVE: Evaluation of gatifloxacin 0.3% ophthalmic solution efficacy in a corneal ulcer model of Pseudomonas keratitis. METHODS: Heptanol-induced corneal ulcers in New Zealand White rabbits (n = 41; 8 females/group) were inoculated with 10(6) CFU of Pseudomonas aeruginosa. Gatifloxacin 0.3% dosing varied among 4 groups with frequencies of 16-48 doses/day (days 1-2), 3-16 doses/day (days 3-7), and maintenance dosing of 3-4 doses/day (days 8-22). Ciprofloxacin 0.3% was administered as labeled for corneal ulcers, with 44 doses on day 1, 16 doses on day 2, and 4 doses/day on days 3-21. RESULTS: All eyes showed evidence of infection by 48 hours postinoculation with 36 of 41 eyes (87.8%) exhibiting moderate-to-severe keratitis. All eyes exhibited corneal healing by day 15, with no significant differences among groups. Three of 4 groups receiving gatifloxacin tended to have smaller fluorescein retention area scores than did the ciprofloxacin group. No eyes tested positive for Pseudomonas at the end of the study. No corneal precipitates were found following as many as 48 doses/day of gatifloxacin. CONCLUSION: Ophthalmic gatifloxacin 0.3% is at least as effective as ciprofloxacin at healing corneal ulcers infected with Pseudomonas aeruginosa when gatifloxacin is administered less frequently than ciprofloxacin. Trends favored gatifloxacin in fluorescein retention scores.

Animals↗

PubMedDate not supplied

Efficacy of cell wall Pseudomonas aeruginosa vaccines for protection against experimental pneumonia.

Three cell wall-derived Pseudomonas aeruginosa vaccines were evaluated for their capacity to provide protection from experimental pseudomonas pneumonia in guinea pigs. Two vaccines, Pseudogen, a heptavalent lipopolysaccharide vaccine, and PEV-01, a polyvalent glycine-EDTA cell wall extract, each produced hemagglutinating, opsonic, and serum bactericidal antibodies in guinea pigs. Significant protection from fatal hemorrhagic pneumonia was conferred by vaccination with these products. Purified, high-molecular weight polysaccharide vaccine was a less potent immunogen in guinea pigs and provided less protection from pneumonia. Protection from fatal pneumonia in vaccinees correlated with more rapid clearance of viable P. aeruginosa from lung tissue during the first 6 hr of infection. It appears that active immunization with certain cell wall-derived pseudomonas antigens can provide protection against experimental pseudomonas pneumonia.

Animals↗

PubMed1980

Evidence for the role of toxin A in the pathogenesis of infection with Pseudomonas aeruginosa in humans.

Levels of antibody to toxin A of Pseudomonas aeruginosa were determined by a solid-phase radioimmunoassay. Mean (+/- SEM) peak levels of IgG in 24 normal soldiers were 2.6 +/- 0.5 microgram/ml, white mean peak levels in 12 patients colonized with and 13 patients infected in sites other than the blood with toxin A-producing strains were 16.7 +/- 7.0 and 17.1 +/- 4.4 microgram/ml, respectively. Levels of IgG were determined in 52 patients with pseudomonas bacteremia, and those surviving and those dying of bacteremia due to toxin A-producing strains had mean peak levels of 25.8 +/- 5.5 and 4.6 +/- 2.0 microgram/ml, respectively. The antitoxin response in sequential bacteremic sera began shortly after onset of bacteremia and decreased gradually, but antitoxin could be recalled promptly upon reinfection with Pseudomonas. Death from pseudomonas bacteremia was significantly associated with infection by a toxin A-producing strain, presence of underlying disease, hypotension, and antitoxin level of < 2 microgram/ml.

Adult↗

PubMed1989

Pseudomonas osteochondritis complicating puncture wounds of the foot in children: a 10-year evaluation.

From 1978 to 1988, microbiologically proven Pseudomonas osteochondritis and septic arthritis following nail puncture wound to the foot was diagnosed in 77 children aged 18 mo-19 y (77 and 17 cases, respectively). The syndromes were found in children with a history of wearing tennis shoes (70 cases), other shoes (5), and no shoes (2). All cases had surgical debridement of the infected cartilage or bone and drainage of infected joints. Pseudomonas aeruginosa was isolated in 38 cases and in conjunction with Staphylococcus aureus in 18. Anti-Pseudomonas antibiotics were initiated in all cases before surgical exploration; the average duration of treatment was 7.5 +/- 1.2 d postoperatively. Patient follow-up was 5.2 +/- 3.4 y (median, 4.8 y; range, 3 mo-10 y). Two relapses occurred; both patients had a previously undetected septic arthritis. These data suggest that with aggressive surgical management, Pseudomonas osteochondritis and septic arthritis can be treated effectively with postoperative antibiotics for 7 d.

Adolescent↗

PubMed1988

The epidemiology of gentamicin-resistant Pseudomonas aeruginosa on an intermediate care unit.

The authors conducted a prospective six-month study of colonization by gentamicin-resistant Pseudomonas aeruginosa on an intermediate care unit at a Cleveland, Ohio hospital with the use of selective culture techniques, serotyping, and plasmid analysis. Thirty-five of 163 patients (21%) were culture positive at least once for gentamicin-resistant Pseudomonas aeruginosa. Patient samples, environmental cultures, and personnel hand cultures revealed no common source for the organisms. Plasmid profiling added little to the serotyping data. Only nonambulation and length of stay on the unit were significant independent risk factors for colonization with gentamicin-resistant Pseudomonas aeruginosa by multiple logistic regression analysis. Age, use of urinary catheters, exposure to antibiotics, and duration of antibiotic use were correlated with one or both of the independent risk factors, but were not themselves independently associated with colonization by these resistant organisms. Cross-colonization apparently was not an important mode of dissemination of gentamicin-resistant Pseudomonas aeruginosa on this intermediate care unit. The identified risk factors appear to be more important than cross-colonization, and control strategies should address these issues.

Adult↗