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PubMed1988

Osteomyelitis of the maxilla with associated vertical root fracture and Pseudomonas infection.

Osteomyelitis of the maxilla is not often found. A rare case of this condition secondary to a chronic vertical root fracture of a maxillary lateral incisor, with Pseudomonas aeruginosa as the primary pathogen, is presented. Interesting features of this case report are the occurrence of osteomyelitis in the maxilla, the rare isolate of P. aeruginosa, and the clinical problems associated with the diagnosis of vertical root fractures. The combination of surgical, endodontic, and antimicrobial therapy used is described.

Adult↗
PubMed2003

Effector ExoU from the type III secretion system is an important modulator of gene expression in lung epithelial cells in response to Pseudomonas aeruginosa infection.

Pseudomonas aeruginosa is an important pathogen in immunocompromised patients and secretes a diverse set of virulence factors that aid colonization and influence host cell defenses. An important early step in the establishment of infection is the production of type III-secreted effectors translocated into host cells by the bacteria. We used cDNA microarrays to compare the transcriptomic response of lung epithelial cells to P. aeruginosa mutants defective in type IV pili, the type III secretion apparatus, or in the production of specific type III-secreted effectors. Of the 18,000 cDNA clones analyzed, 55 were induced or repressed after 4 h of infection and could be classified into four different expression patterns. These include (i) host genes that are induced or repressed in a type III secretion-independent manner (32 clones), (ii) host genes induced specifically by ExoU (20 clones), and (iii) host genes induced in an ExoU-independent but type III secretion dependent manner (3 clones). In particular, ExoU was essential for the expression of immediate-early response genes, including the transcription factor c-Fos. ExoU-dependent gene expression was mediated in part by early and transient activation of the AP1 transcription factor complex. In conclusion, the present study provides a detailed insight into the response of epithelial cells to infection and indicates the significant role played by the type III virulence mechanism in the initial host response.

Bacterial Proteins↗
PubMed1983

Reduced sensitivity to beta-lactam antibiotics arising during ceftazidime treatment of Pseudomonas aeruginosa infections.

Pseudomonas aeruginosa isolated from two patients with empyema and one with bronchopneumonia became less sensitive after treatment with ceftazidime, while Ps. aeruginosa persisted in a patient with an infected compound fracture of the tibia treated with ceftazidime but did not become less sensitive. The reduction in sensitivity to ceftazidime, which was small, was accompanied by resistance to azlocillin but there are little reduction in sensitivity to carbenicillin. The resistant strains produced increased amounts of the chromosomally-mediated cephalosporinase produced by most isolates of Ps. aeruginosa. Variants with reduced sensitivity to ceftazidime, which resembled those that developed in vivo, were selected in vitro from each of the initial ceftazidime-sensitive isolates.

Adult↗
PubMed2003

The genome of bacteriophage phiKMV, a T7-like virus infecting Pseudomonas aeruginosa.

The complete DNA sequence of a new lytic T7-like bacteriophage phiKMV is presented. It is the first genome sequence of a member of the Podoviridae that infects Pseudomonas aeruginosa. The linear G + C-rich (62.3%) double-stranded DNA genome of 42,519 bp has direct terminal repeats of 414 bp and contains 48 open reading frames that are all transcribed from the same strand. Despite absence of homology at the DNA level, 11 of the 48 phiKMV-encoded putative proteins show sequence similarity to known T7-type phage proteins. Eighteen open reading frame products have been assigned, including an RNA polymerase, proteins involved in DNA replication, as well as structural, phage maturation, and lysis proteins. Surprisingly, the major capsid protein completely lacks sequence homology to any known protein. Also, the strong virulence toward many clinical P. aeruginosa isolates and a short replication time make phiKMV attractive for phage therapy or a potential source for antimicrobial proteins.

Amino Acid Sequence↗
PubMed1988

Serious Pseudomonas infections associated with endoscopic retrograde cholangiopancreatography.

After observing a single case of Pseudomonas aeruginosa bacteremia following endoscopic retrograde cholangiopancreatography (ERCP), six other P. aeruginosa infections that were temporally related to ERCP were retrospectively found over one year (August 1985 through July 1986) at LDS Hospital. In all seven patients, infection developed within five days after an ERCP. Five patients had bacteremia and two had cholangitis. All five of the Pseudomonas isolates available for testing were serotype 010. Cultures from the ERCP endoscope and several other endoscopes also yielded P. aeruginosa serotype 10, as did environmental cultures from equipment used to clean endoscopes. Among 167 ERCPs performed during the outbreak period, no other patient acquired P. aeruginosa infection. Each of the patients in the outbreak received the first scheduled ERCP of the day. The mean duration between the cleaning of the ERCP endoscope and its subsequent use was significantly longer in cases than in matched controls, a factor that may have permitted contaminating organisms to achieve high inocula in the inadequately cleaned endoscope. Epidemic control measures included improved disinfection of endoscopes, ongoing surveillance, and appropriate antimicrobial prophylaxis. This experience suggests that exogenous infection with Pseudomonas is associated with ERCP, that protracted and insidious outbreaks may occur, and that the occurrence of even a single case of Pseudomonas infection after ERCP should stimulate an epidemiologic investigation.

Cholangiopancreatography, Endoscopic Retrograde↗