Pseudomonas infection. Antibiotic therapy for hospital infections caused by P. aeruginosa

Pseudomonas aeruginosa is a pathogenic microorganism that lives in the human body, and under certain conditions can cause severe infectious diseases.

How can you get infected with Pseudomonas aeruginosa, what is the danger of a microbe, and what to do if a Pseudomonas aeruginosa occurs?

What is Pseudomonas aeruginosa

The causative agent, pseudomonas aerugenosa, belongs to the category of opportunistic microbes, that is, those that can normally be present in absolutely healthy people. At a sufficiently high multiplication of microbes is blocked by the intestinal microflora. But with a weakening of the body's defenses and with a massive seeding of pathogenic microorganisms, the bacterium causes a disease.

Pseudomonas aeruginosa is considered the most common "nosocomial pathogen", because. Basically, the infection affects patients who are forced to stay in a hospital for a long time.

Note! Pseudomonas aeruginosa is found in approximately 3-5% of people, while the bacterium is part of the normal microflora.

What is the danger of Pseudomonas aeruginosa:

• The bacterium is often found normally on the mucous membranes, skin, and gastrointestinal tract in absolutely healthy people.
• The causative agent quickly acquires resistance to antibacterial and disinfectants.
• The microorganism is resistant to the external environment: it tolerates UVA rays, temperature changes, lack of nutrients, etc.
• The microbe is widely distributed in the environment, especially in untreated wastewater, in soil, in the intestines of birds, animals, and humans.
• The bacterium can "attach" to non-biological objects (surgical instruments, endoscopes, etc.).
• A colony of microbes forms a specific biofilm that is resistant to adverse environmental factors.

The bacterium enters the human body through mucous membranes and damaged tissues, while the localization of the bacterium depends on the route of its penetration. For a long time, a pathogenic microorganism may not manifest itself in any way, but with a sharp decrease in immunity or injury, the bacterium begins an active attack on the organs and systems of the human body.

When the pathogen and Pseudomonas aeruginosa interact, a Pseudomonas aeruginosa infection is formed, which goes through three stages:

1. The bacterium penetrates the tissues and multiplies - the primary focus of infection is formed.
2. The pathogen begins to penetrate deep tissues - the infection spreads locally, but its action is still blocked by the body's defenses.
3. The microbe enters the systemic circulation, through which it spreads through tissues and organs.

For the emergence and spread of the infectious process, a large number of bacteria is necessary, which is impossible under the condition of the normal functioning of the immune system. Therefore, the infection most often affects debilitated patients, the elderly and children.

The microbe is very difficult to destroy - ordinary sanitary measures (treatment of medical equipment, hospital premises, etc.) do not work, and Pseudomonas aeruginosa quickly develops resistance to antibiotics.

Ways of transmission of Pseudomonas aeruginosa

The source of transmission of the infection is the person himself, who is a carrier of the microbe or is already sick with Pseudomonas aeruginosa infection. In terms of infection, patients with purulent wounds and pneumonia caused by Pseudomonas aeruginosa are of particular danger.

Entrance gates for infection are open wounds, umbilical wound, gastrointestinal tract, respiratory organs, urinary system, conjunctiva of the eyes. The pathogenic microbe quickly adapts in the human body and after infection, the infectivity increases several times, that is, the sick patient is the most dangerous source of infection.

In the conditions of a medical hospital, further transmission of the pathogen is carried out through any objects of the hospital environment and through the medical staff themselves.

Important! Almost 50% of nosocomial infections are caused by Pseudomonas aeruginosa. Factors contributing to the spread of infection in the hospital are the neglect of the rules of antisepsis and asepsis.

How is Pseudomonas aeruginosa transmitted:

• Contact-household way - through household items: doorknobs, towels, toilet bowls, faucets and sinks. In rare cases, the pathogen is transmitted through the hands of medical staff, tools, medical equipment, which have not been sanitized enough.
• Ingestion - through contaminated food and water.
• Airborne - inhalation of air containing a stick.

A person can become a source of illness for himself if he has an immunodeficiency state, and Pseudomonas aeruginosa settled in the intestine earlier. Prolonged antibacterial and hormonal therapy, as well as autoimmune pathologies, can contribute to a sharp decrease in protective forces.

Risk factors for nosocomial infection:

• Long stay in the hospital;
• Therapy with broad-spectrum hormones or antibiotics, carried out for a long time;
• Respiratory diseases (chronic, bronchiectasis);
• The use of penetrating methods of therapy and observation (introduction of a probe into the stomach, artificial ventilation of the lungs, bladder catheterization, etc.);
• Childhood and old age;
• Neurosurgical operations.

Note! The risk group from medical institutions includes burn centers, purulent surgery departments and maternity hospitals.

The emergence of hospital infections is associated not only with a poorly organized sanitary and anti-epidemic regime in a hospital, but also with the constant development of pathogen resistance to disinfectants and antibiotics.

Manifestations and consequences of Pseudomonas aeruginosa

From the moment of infection to the manifestation of the first symptoms of infection, several hours and even days (2-5 days) may pass. The infection can develop in a separate organ or system, but combined lesions can also occur.

Symptoms of infection depend on the location of the pathogen:

• Nervous system. Clinical damage to the nervous system leads to the development of meningoencephalitis and. Both pathologies are quite difficult and often end in death.
• Eyes. The microbe causes ulceration of the cornea, photophobia, profuse lacrimation, severe burning and pain in the eyes. If the inflammatory process passes to the subcutaneous fat of the orbit of the eye, the eyeball begins to protrude from the orbit, and the skin around it becomes edematous and acquires a red tint.
• Zev. Pseudomonas aeruginosa in the throat causes the following symptoms: redness and swelling of the mucous membrane of the throat, inflammation of the tonsils, sore throat, cracks in the mucous membranes of the lips. When the process spreads to the nasopharynx, sticky, mucous discharge from the nose appears.
• Gastrointestinal tract. The infectious process proceeds in the form of food intoxication - vomiting, abdominal cramps, nausea, loose copious stools occur, appetite disappears.
• Nose. Pseudomonas aeruginosa in the nose can lead to prolonged and chronic inflammation of the sinuses (frontitis,).

  

• Skin covers. The pathogen actively multiplies in cuts, wounds, burns, ulcers, which leads to a purulent process. Pus has a characteristic blue color.
• urinary tract. Pseudomonas aeruginosa in the urine leads to the development,. The pathological process is manifested by pain in the lumbar region and lower abdomen, frequent urination.
• Ears. Pseudomonas aeruginosa in the ear provokes purulent, in which bloody and purulent discharges from the ears are observed, hearing impairment occurs, and severe pain in the ear is disturbing.
• Respiratory system. Pseudomonas aeruginosa often leads to the development of pneumonia, in which there is a pronounced discharge of purulent sputum, shortness of breath, chest pain. If the infection affects the upper respiratory tract, this manifests itself in the form of the development of chronic and acute,.
• Nails. The causative agent can be localized between the nail plate and the nail bed. Moisturizing promotes the reproduction and growth of bacteria, while the nail plate darkens and softens, and the infection penetrates deeper into the tissues. Pseudomonas aeruginosa on the nails can cause exfoliation of the nail plate, spots of unusual color (brown-brown, blue-green, orange, bright red) may appear on the nail plate. At this stage, treatment should be started urgently to prevent the infection from spreading to the soft tissues of the fingers.

  

All of the above symptoms are accompanied by a general deterioration in the patient's well-being, fever, weakness, headache.

Pseudomonas aeruginosa infection does not have a characteristic and any specific clinical picture. Suspicions of infection usually arise already at the stage of therapy, when antibiotic treatment does not work.

Therefore, the diagnosis of "pseudomonal infection" can only be made after laboratory tests:

• General analyzes of urine, feces, blood;
• Radiography;
• Lumbar puncture;
• Detection of the pathogen by PCR, bacteriological or serological method.

The consequences of Pseudomonas aeruginosa depend on which organ and system the infection has spread to. These can be: meningitis, pneumonia, purulent otitis media, rhinitis, keratitis, abscess, etc.

How to Treat a Pseudomonas Infection

Patients with Pseudomonas aeruginosa infection are treated necessarily in a hospital with strict bed rest. The therapy is carried out by a complex method and includes antibiotic therapy, symptomatic treatment, the use of probiotics, restorative treatment and therapy of the underlying disease.

One of the ways to combat Pseudomonas aeruginosa is a set of measures to prevent its formation in the hospital environment: personal hygiene by medical staff, sanitation of instruments, dressings, and change of disinfectants.

Medical therapy

The use of antibiotics is the main condition for the treatment of Pseudomonas aeruginosa. The choice of an antibacterial agent is made after laboratory determination of the sensitivity of the pathogen to a particular drug.

Most often, the choice falls on antibacterial drugs:

• Ceftazidime;
• Cefepime;
• Carbapenems;
• Amikacin;
• Ciprofloxacin.

First, the drug is usually administered intravenously, and after the first positive results are obtained, the antibiotic is started to be administered intramuscularly. In parallel, if necessary, you can use the local application of antibacterial drugs: the imposition of lotions, ointments, compresses on the affected area.

Note! The duration of drug treatment can be from two to six or more weeks.

During the period of therapy, a bacteriological examination for the sensitivity of the pathogen to antibiotics is repeated. If treatment with antibacterial drugs does not give results within 3-5 days, then the drugs are replaced.

For the effectiveness of therapy, bacteriophage preparations are added to antibiotics. These are special viruses that cause the death of Pseudomonas aeruginosa.

Pseudomonas aeruginosa bacteriophage (intestibacteriophage, pyocyoneus, pyobacteriophage) can be administered as an enema, applications, tampons, orally or injected into various cavities (in the sinuses, uterus, bladder, etc.).

Bacteriophage preparations are selected on an individual basis, and they are treated for 5-14 days, after which the course is repeated if necessary.

To restore normal microflora after illness and the use of antibiotic therapy, probiotics (Lactobacterin, Biosporin, Linex, Acipol) and prebiotics (Lactulose) are prescribed.

For a general strengthening of the body, a fortified diet, the intake of immunomodulators and vitamin-mineral complexes are prescribed.

Folk remedies

Treatment of Pseudomonas aeruginosa with folk methods has a general strengthening effect on the body and is used in combination with medications, but by no means instead of them.

Folk recipes:

• Kalina. Rub viburnum berries well, and pour a large spoonful of berries on the floor with a liter of boiling water. Infusion drink four times a day before meals for half a glass.
• Tea tree oil. Dissolve a drop of tea tree oil in a teaspoon of ordinary vegetable oil (or olive oil) or drop it into a bread crumb. Take the drug on an empty stomach and drink plenty of water.
• Propolis. Dilute propolis with warm water in a ratio of 1:10. The remedy is used externally, as lotions and compresses on the affected areas of the body.
• Decoction from lingonberry leaves or aspen leaves, bird mountaineer leaves, horsetail leaves, plantain leaves. Any of the listed plants (or each in equal proportions) is taken in the amount of two tablespoons and brewed as tea in a thermos. Drink instead of regular tea, but no more than three times a day.

As lotions or rinses, you can use purchased local preparations: calendula infusion or Chlorophyllipt solution.

Pseudomonas aeruginosa in children

Pseudomonas aeruginosa is 10 times more common in children than in adults. At risk are newborns in the first months of life and premature babies. It is at this age that babies are more susceptible to infection, and therefore prone to infection with a “hospital germ”.

Note! Pseudomonas aeruginosa in infants most often enters the body through the intestines and umbilical cord. The disease is acute and with complications.

At preschool age, the infection most often develops against the background of a weakening of the protective forces, with prolonged treatment with antibiotics, with open burns and wounds.

Pseudomonas aeruginosa in children is treated with antibiotics, while the drug, its dosage and the duration of the course of therapy are determined individually.

In infants, antibiotic therapy must necessarily be combined with breastfeeding, because. mother's milk acts as a probiotic and helps the baby to increase the body's defenses.

Dr. Komarovsky recommends not to get carried away with immunomodulatory drugs for children, but rather to protect children weakened after illness from external contacts, ensure proper nutrition and teach them to follow hygiene rules and norms.

The detection of Pseudomonas aeruginosa is not a reason for treatment if the microbe did not cause an inflammatory process and did not develop into a Pseudomonas aeruginosa infection.

It is extremely difficult to make a prognosis for Pseudomonas aeruginosa, due to the high resistance of the microbe to antibacterial agents and the tendency to chronic long-term course. Even if the pathology is not severe, it significantly worsens the quality of life and is fraught with constant exacerbations.

The success of the treatment of the infection depends on the timely detection of the infection and the conditions of the clinic where therapeutic measures will be carried out.

Pseudomonas aeruginosa is a particularly pathogenic bacterium that can be easily acquired during hospital treatment; its transmission in everyday life is possible, but this happens less often. Most often, the microbe “lives” in intensive care units, because they have a large amount of equipment and tools that are used repeatedly. At the same time, he is not sensitive to many antiseptics, and some, for example, rivanol, use “for food”. Bacteria and some kind of "collective mind" are attributed.

The essence of the story about Pseudomonas aeruginosa and the diseases that it causes is not to be treated on your own or not to go to the hospital (after all, its concentration is greater in hospital walls than on the street or at home). The point is to do everything possible so that the disease does not require intensive care (there are people who insist on treatment in the intensive care unit). This concept includes a planned examination, a visit to a doctor when some incomprehensible symptoms appear, as well as proper nutrition, sufficient activity and maintenance - without fanaticism - of the cleanliness of the skin.

About bacteria

Pseudomonas aeruginosa (Pseudomonas aeruginosa) lives in the environment. It can be found:

• on the ground;
• on plants;
• in the air;
• on objects: washbasins, air conditioners, humidifiers, faucets, in household liquids - in a small amount.

Also, trace (minimal) volumes of microbes can be found in the composition of the normal microflora of the skin of the armpits, inguinal folds, near the nose or ear. The bacterium behaves peacefully while the local immunity of a person (pH of his skin, the level of immunoglobulins A in his epidermis, the bactericidal properties of saliva, the contents of the nasopharynx and gastric juice), as well as the general protective properties of the body are maintained at a sufficient level.

If any of the parameters suffer, or Pseudomonas gets in large quantities, or it is “delivered” to the internal environment of the body, an infection of Pseudomonas aeruginosa develops. Its symptoms will depend on which organ the microbe has entered. So, it can become the causative agent of encephalitis, or. It is able to multiply in the intestines, middle ear, abscesses and wounds.

Pseudomonas aeruginosa cannot live in the absence of oxygen. Because of this, it is called an obligate (that is, obligatory) aerobe. It is a Gram-negative microbe, which means it has a structure-based coloration when certain dyes are used. Gram-negative bacteria are more pathogenic, due to the structure of their cell wall. They form little toxic metabolic products, but when they are destroyed by immunity cells, an internal factor previously localized on the membrane is released, which causes poisoning of the body and can cause shock that is difficult to cure (all internal organs are affected).

Pseudomonas aeruginosa has a size of 0.5 microns. It looks like a stick, the ends of which are rounded. There are 1 or more flagella, which not only help the bacteria move, but are also additional factors of aggression. It is by the type of flagellar antigen protein that 60 species of bacteria are distinguished, which differ in their toxigenic properties.

The bacterium grows best at a temperature of 37 degrees, but continues to exist at higher temperatures - up to 42°C. The environments where Pseudomonas aeruginosa develops are meat-peptone broth, meat-peptone agar, and nutrient agar (a jelly-like substance) saturated with cetylperidinium chloride. So, if when sowing material taken from a patient (sputum, discharged from a wound, urine, cerebrospinal fluid or blood) and placed on these media, “dots” of blue-green staining appear, this indicates that the causative agent of the infection is Pseudomonas aeruginosa pseudomonad. Next, microbiologists study the properties and type of bacteria, its sensitivity to antibiotics, so that the attending physician who received such a result would know how to treat a person.

A similar microbiological study - sowing on nutrient media - is periodically carried out in each of the departments of the hospital to assess the quality of sterilization of instruments and equipment. If the culture reveals a Pseudomonas, additional disinfection is carried out. This is much more cost-effective than treating a person with Pseudomonas aeruginosa, so such studies, especially in intensive care units, anesthesiology and resuscitation, are really being carried out.

Pseudomonas aeruginosa produces pigments:

• pyocyanin: it is he who colors the medium in a blue-green color;
• pyoverdin: a yellow-green pigment that fluoresces when the nutrient medium is exposed to ultraviolet irradiation;
• pyorubin is a brown pigment.

The bacterium is resistant to many disinfectant solutions due to the production of special enzymes that break them down. Can only destroy her:

1. boiling;
2. autoclaving (steam sterilization under high pressure conditions);
3. 3% peroxide;
4. 5-10% solutions of chloramine.

"Weapon" bacteria

Pseudomonas aeruginosa "strike" the human body due to the fact that:

• can move with the help of flagella;
• produces a toxin as a product of its own vital activity, that is, until its death;
• produces substances that: "burst" erythrocytes, infect liver cells, kill leukocytes - immune cells that are designed to fight any infection;
• synthesizes substances that kill other "competitor" bacteria at the site of entry;
• "stick" to surfaces and to each other, becoming covered with a common "biofilm", insensitive to antibiotics, antiseptics and disinfectants. So pseudomonas colonies live on catheters, endotracheal tubes, respiratory and hemodialysis equipment;
• there are enzymes that allow you to move through the intercellular space;
• synthesize phospholipase, which destroys the main part of the surfactant - a substance due to which the lungs do not "stick together" and can breathe;
• produces enzymes that break down proteins, so the bacterium causes tissue death in the place of its accumulation in sufficient quantities.

Another feature of the pseudomonad is that it has many factors that prevent bacteria from being destroyed by antibiotics. It:

• enzymes that break down the main bactericidal substance of antibiotics such as penicillin, ceftriaxone, cephalexin and others;
• defects in proteins that close the pores - "gaps" in the cell wall of microbes;
• the ability of a microbe to remove a drug from its cell.

Epidemiological moments

How is Pseudomonas aeruginosa transmitted. There are such ways of transmission:

1. airborne (when coughing, sneezing, talking);
2. contact (through household items, tools, doors, towels, taps);
3. food (through insufficiently processed milk, meat or water).

The infection can get through:

• damaged skin or mucous membranes;
• umbilical wound;
• conjunctiva of the eyes;
• mucous membrane of any internal organ: bronchi, urethra, bladder, trachea;
• gastrointestinal tract - when food contaminated with bacteria has entered it.

Most often, however, Pseudomonas aeruginosa gets from its own body: from the upper respiratory tract or intestines, where it can be normal, in small quantities. "Share" Pseudomonas aeruginosa can:

1. a person in whom she lives in the lungs (and at the same time he coughs);
2. when a person suffers from Pseudomonas aeruginosa (inflammation of the oral mucosa) - then he secretes pseudomonas when talking and sneezing;
3. the carrier of the bacterium (that is, a healthy person), when the pseudomonad inhabits the oropharynx or nasopharynx;
4. when food is prepared by a person who has purulent wounds on his hands or exposed parts of the body.

The main way, however, is when carrying out manipulations in a hospital.

We repeat: a bacterium can cause a disease if:

• she hit in large numbers;
• it was "brought" to where it should be absolutely sterile;
• it got into damaged skin or mucous membranes in contact with the external environment (lips, nose, conjunctiva, mouth, pharynx, genitals, external opening of the urinary canal, anus);
• reduced local immunity of the mucous membrane or skin;
• the defenses of the body as a whole are reduced.

The microorganism is better "fixed" on the mucous membranes if a person who has received a certain dose of it in any of the ways has then visited a bath, pool or sauna.

Who is at risk for infection

The pathogen is especially dangerous for:

• the elderly over 60;
• children of the first three months of life;
• weakened people;
• patients with cystic fibrosis;
• requiring hemodialysis;
• sick;
• sick;
• who received burns;
• people who have undergone organ transplants;
• long receiving hormonal drugs (for example, for treatment, or other systemic diseases);
• having malformations of the genitourinary system;
• suffering;
• forced to stay in the hospital for a long time.

It is also possible to predict which disease of pseudomonas etiology will develop - by age, primary pathology or manipulation

The most commonly affected patients are:

• intensive care;
• burn;
• surgical, in which operations are performed on the abdominal cavity, as well as abscesses and carbuncles are opened;
• cardiac surgery.

Diseases caused by Pseudomonas aeruginosa

Pseudomonas aeruginosa causes various diseases, depending on the place where the infection enters. According to statistics, it is the causative agent:

• about 35% of all diseases of the urinary system;
• almost a quarter of all purulent surgical pathologies;
• 5-10% of all community-acquired pneumonias;
• and 10-35% of those inflammations of the lung tissue that developed on the third day or later after admission to the hospital.

Getting into any organism, Pseudomonas aeruginosa goes through three stages of development:

1. It attaches to the tissue through which it has entered, and then begins to multiply there. This forms the primary focus of infection.
2. It spreads from the primary focus to deeper tissues.
3. Absorption of a bacterium with all its enzymes and toxins into the blood, and then the pseudomonas with the bloodstream spreads to other organs. So, the appearance of soft tissue phlegmon can at that stage lead to the formation of pneumonia, and even damage to the substance of the brain.

By symptoms alone, it is impossible to say that the causative agent of the disease is Pseudomonas aeruginosa, since it causes the same pneumonia, gastroenteritis, as well as other bacteria (Klebsiella, Staphylococcus aureus). This particular microbe can be suspected either by the fact that a person has recently been treated in a hospital, or by the ineffectiveness of starting antibiotic therapy (when a “regular” antibiotic was prescribed, but the temperature continues to hold, and the blood count does not improve).

The main symptoms of Pseudomonas aeruginosa infection

Below are signs of diseases caused by Pseudomonas aeruginosa, when antibiotic treatment has not yet been carried out. If a person received therapy, the clinical picture (that is, symptoms) is most often blurred, not pronounced.

Pseudomonas aeruginosa infection of the upper respiratory tract

If Pseudomonas "settles" in the pharynx, the following symptoms occur:

• sore throat, aggravated by swallowing;
• temperature rise;
• red and swollen tonsils;
• cracked lips.

If a Pseudomonas Infection Develops in the Throat, then appear:

• cough, usually dry, that occurs after, worsens when taking a horizontal position;
• temperature rise;
• weakness;
• fast fatiguability.

If the pathogen "settled" in the nose, this leads to the development of a prolonged runny nose, a feeling of nasal congestion, decreased sense of smell, periodic headaches (more often on the one hand, more in the forehead).

Pseudomonas aeruginosa in the ear causes otitis externa, which manifests itself:

• ear pain;
• the appearance of a yellow-greenish-bloody thick discharge from it;
• hearing impairment;
• rise in temperature.

To contact an ENT doctor, purulent discharge from the ear alone should be enough. Self-treatment is dangerous, since otitis externa of Pseudomonas aeruginosa etiology can progress rapidly, leading to inflammation of the middle ear, accumulation of pus in the airways of the mastoid process, and even inflammation of the meninges.

Pseudomonas aeruginosa infection of the digestive system

If a sufficient number of Pseudomonas is in the intestine, symptoms of infectious gastroenterocolitis develop. It:

• at first - vomiting of recently eaten food, pain "in the pit of the stomach";
• then the pain moves to the navel and becomes more diffuse;
• weakness occurs;
• loss of appetite;
• nausea appears;
• the temperature rises to small numbers (does not reach 38);
• frequent stools: up to 7 times a day, mushy, greenish; it has streaks of blood and/or mucus;
• everything ends in 3-4 days without treatment, but the infection becomes chronic (less often, asymptomatic carriage). Pseudomonas aeruginosa, gram-negative sepsis may develop if a similar condition has developed in an HIV-infected person, someone who has undergone an organ transplant, is treated with glucocorticoid hormones, or has recently undergone chemotherapy or radiation therapy.

Pseudomonas aeruginosa infection of the urinary system

This is a number of diseases - pyelonephritis, cystitis - which are diagnosed by the presence of Pseudomonas aeruginosa in the urine.

Such pathologies do not develop from scratch. People suffer:

1. with reduced immunity;
2. having anomalies in the development of the organs of the genitourinary system;
3. suffering from kidney stone disease;
4. who often have to catheterize the bladder (for example, with).

Symptoms of pseudomonas lesions of the urinary system are not specific. This pain in the lower back, cutting pain when urinating, painful urge to urinate, a feeling of incomplete emptying of the bladder, fever, change in color and smell of urine.

It is characteristic that the course of such a disease is long, when periods of exacerbation with the above symptoms alternate with asymptomatic time intervals. At the same time, "Norfloxacin", "Monural" or "5-nitroxoline" do not have a significant effect. So Pseudomonas urinary tract infection can last for several months or years.

Pseudomonas aeruginosa infection of the respiratory system

The most dangerous of these diseases is pneumonia. It rarely develops in a completely healthy person, only in children of the first two years of life. In adults, Pseudomonas aeruginosa actively settles only:

1. in a large amount of stagnant mucus - with cystic fibrosis, chronic bronchitis, bronchiectasis;
2. if a person was transferred to artificial (hardware) respiration. This could occur during anesthesia, but more often if he developed viral pneumonia, myasthenia gravis, or impaired consciousness.

Pseudomonas aeruginosa occurs with fever, signs of intoxication (weakness, lack of appetite, nausea) and respiratory failure (this is shortness of breath, feeling short of breath). Mucopurulent sputum is discharged.

Even before the results of bacteriological culture of sputum, Pseudomonas aeruginosa infection in the lungs can be suspected if the x-ray shows large areas of inflammation that do not disappear and may even increase in area after the start of antibiotic therapy.

Pseudomonas aeruginosa infection of the skin and underlying soft tissues

You can “catch” Pseudomonas aeruginosa in the pool, jacuzzi, while taking therapeutic baths. Especially sensitive to it will be the skin of a person with diabetes, or malnourished.

First, folliculitis develops at the site of the bacterium - an abscess, in the middle of which there is a hair, and around it is a pink rim. Such an element itches, but does not hurt. If a person's immunity resists, then the case is limited to folliculitis. In its place, a brown or yellowish crust appears, then a dark spot may persist for some time.

If the infection has penetrated into the deeper layers of the skin, especially if the injured area was placed in a humid environment (the bandage or diaper was not changed in the child), or Pseudomonas aeruginosa settled on the burn surface, the following symptoms appear:

• blue-green purulent discharge from the wound;
• redness of the affected area, which can spread over the area;
• a purple, black or brown crust appears on the wounds;
• after the rejection of one crust, a second one forms in its place.

The process may end:

1. recovery;
2. - tissue death to the full depth;
3. abscess - a delimited cavity filled with pus;
4. sepsis, when the infection is absorbed into the blood, and then it spreads through the internal organs, causing damage to them of varying severity.

Other localizations of Pseudomonas aeruginosa

P.aeruginosa can cause it and:

• osteomyelitis;
• eye infections: purulent conjunctivitis, corneal ulcer, purulent lesion of all membranes of the eye;
• endocarditis - inflammation of the inner lining of the heart;
• meningitis, meningoencephalitis. In that case, the bacterium enters the nervous system either during operations on it, or as a result of spinal anesthesia, or with blood flow from an organ affected by Pseudomonas aeruginosa.

Pseudomonas aeruginosa infection in children

Pseudomonas aeruginosa in a child can enter different organs and tissues:

1. Into the umbilical cord. Then the skin area around the navel turns red, begins to ooze. The purulent discharge from it may have a greenish color. The general condition of the child is also disturbed: he becomes lethargic, screams when he touches his stomach, refuses to eat. The temperature rises.
2. on the burn surface. Burnt tissues turn red, and the redness spreads quickly, even to healthy skin. There is purulent discharge from wounds. The temperature rises. The appetite disappears, the child is restless, but drowsiness gradually increases. Signs of dehydration also progress: dryness of the lips increases, the voice becomes quieter, he can no longer cry with tears, and his eyes seem to sink down ().
3. Into the airways, causing purulent bronchitis and. This is typical for children with cystic fibrosis (when the sputum is very viscous). These diseases are manifested by fever, severe weakness (small children sleep all the time), shortness of breath (it is important to count the respiratory rate). Often at a distance dry rales are heard during breathing.
4. Into the gastrointestinal tract- with insufficiently thermally processed food or from the primary focus (in the skin, urinary tract, lungs). In this case, a severe intestinal infection develops. The temperature rises to 38-39 degrees. Vomiting is frequent, profuse. Stool - up to 20 times a day. Signs of dehydration are rapidly growing from which, if urgent help is not provided, the child may die.
   In children older than 2 years, Pseudomonas aeruginosa gastroenterocolitis may have a chronic course: a low temperature persists for 2-4 weeks, the child's stomach is swollen, rumbling. The baby is losing weight.
   If the infection has got with food, then, especially in deeply premature and hypotrophic (that is, with low body weight) children, blood poisoning - sepsis - often develops.
5. In the urinary tract. Usually, the bacterium enters here from the skin of the perineum, on which, due to poor hygiene under the diaper, diaper rash and pustules occur. Sometimes Pseudomonas penetrates the urethra, and moves deeper along it, to the kidneys - during catheterization of the bladder. Pseudomonas aeruginosa infection of the urinary tract is manifested by high fever, a change in the behavior of the child, and nausea. There is no cough and runny nose, urine does not always change its color, texture or smell. Urinary tract disease can be detected if, at this (parents often call it "dry") temperature, pass urine for a general analysis.
6. In the brain or its membranes. The bacterium usually enters here from some primary focus. Meningitis and meningoencephalitis of Pseudomonas aeruginosa etiology are characterized by a monotonous cry, bulging of the fontanel, vomiting, convulsions, impaired consciousness. Older children complain of headaches.

How to recognize Pseudomonas aeruginosa infection

Doctors suggest that the treatment of Pseudomonas aeruginosa is difficult because:

• a person does not seek medical help for a long time, because in many cases (except for skin lesions) the disease has a sluggish course;
• often resorts to self-medication with the first antibiotics offered in the pharmacy, as a result of which the bacterium acquires resistance to them;
• rarely, a bacteriological study is immediately performed - sowing the biomaterial on nutrient media.

Pseudomonas aeruginosa can be detected if bakposev is performed:

• discharge from a wound or drainage;
• sputum - when coughing;
• burn surface;
• blood - in any case, to exclude sepsis;
• urine - if in its general analysis there are signs of a urinary tract infection.

Along with determining the type of P. aeruginosa, bacteriologists should conduct an antibacterial susceptibility test to know which antibiotics are suitable for a particular Pseudomonas aeruginosa.

Pseudomonas infection treatment

It is carried out only in a hospital. Why?

1. If the dose of the microbe was significant, antibiotic treatment of Pseudomonas aeruginosa - and only it can cure, not mask the symptoms - causes the breakdown of microbial bodies, which can cause shock.
2. Only a doctor can determine the appropriateness of antibiotic therapy. So, not only the very fact of detecting a bacterium is important here, but its quantity and the material from which it was isolated.
3. The doctor has the knowledge to help eradicate Pseudomonas aeruginosa. He knows how many days to use this or that antibiotic, in which case it needs to be changed.
4. Only in a hospital is it possible to administer intravenous and intramuscular injections to the patient several times a day, to conduct a blood or urine test correctly and almost daily, and to perform surgical interventions.

It is necessary to decide how to treat Pseudomonas aeruginosa, if it is determined:

• in the blood - in any quantity;
• in sputum - at least 10 5 CFU / ml (CFU - colony forming units);
• in the wound - at least 10 4 CFU / ml;
• in urine - more than 10 5 CFU / ml.

The main treatment is antibiotics, which must first be administered intravenously, then, if their effectiveness has been proven, they are switched to intramuscular administration. At the final stage of treatment, you can switch to tableted antibacterial drugs.

Simultaneously with the systemic administration of antibiotics, it is necessary to wash the infected cavities with antiseptic solutions. So, with cystitis and urethritis, the bladder is washed through an inserted catheter. If by the time Pseudomonas aeruginosa is detected in the sputum, the patient is on a ventilator, then his trachea and bronchi can also be washed with antiseptics. Wounds are washed with drainage.

In the case of Pseudomonas aeruginosa, such treatment is justified when it is started depending on the severity of the condition, prescribing broader spectrum antibiotics from the very beginning:

1. If there are fatal risk factors, such as: shock, disruption of several internal organs, or if mechanical ventilation is necessary, antibacterial agents of the widest spectrum are needed. Today it is "Tienam" (imipenem) or "Meronem". The dosage of the latter will depend on whether the person has a bacterial infection in the brain, or whether the infection is located on the skin, soft tissues, abdominal, thoracic, and pelvic cavity.
2. If Pseudomonas aeruginosa has been isolated from the blood, treatment with Tienam or Meropenem also begins.
3. If before that antibiotics with antipseudomonal activity (Ceftazidime, Fortum, Cefoperazone or Cefepime) were prescribed within the next three weeks, Tienam or Meronem are also needed.
4. If Pseudomonas aeruginosa, wound infection, urinary tract pathology is diagnosed, but the condition has arisen acutely, and before this case, antibiotic treatment was not carried out, Cefepime, Ceftazidime, Ciprofloxacin or Cefoperazone is prescribed.
5. The antibiotic of the reserve is now still Colimycin, which is used when imipenem or meropenem is ineffective.

The minimum course of antibiotic therapy is 7 days, but only a specialist who will be guided by both the clinical picture and the data of analyzes - clinical and bacteriological - should cancel antibiotics.

Additional Treatment

This is the treatment of the disease, against which a Pseudomonas aeruginosa infection (cystic fibrosis, immunodeficiency states) has developed, a bacteriophage and the introduction of antipseudomonal antibodies.

bacteriophage

Pseudomonas aeruginosa can be destroyed not only by antibiotics, but also by a specially created non-contagious virus - an antipseudomonal bacteriophage. Before its appointment, you must first determine the sensitivity to it.

Bacteriophage is effective when locally administered together with antibiotics. So, it can be delivered to the intestine inside or in the form of an enema, to the vagina and bladder - through a thin catheter. It can be injected into the pleural cavity, renal pelvis and sinuses, after installing drainage there.

Bacteriophage can also be used for children, even newborns and premature babies.

autovaccine

Its name is Pseudovac, which is prepared individually, based on a strain isolated from a patient.

Antipseudomonal donor plasma

This is the liquid part of the blood, which can be obtained if the donor is given doses of Pseudomonas aeruginosa that are harmless to his health. Then his body begins to synthesize protection against bacteria - antibodies. Most of them are contained in the plasma, which - taking into account the blood type - is administered to the patient.

Prevention of Pseudomonas aeruginosa

You can avoid infection if:

• timely treat infections: carious teeth, tonsils, wounds;
• maintain immunity at a sufficient level, hardening, eating vegetable and lactic acid foods, playing sports, maintaining body cleanliness;
• monitor the cleanliness of the premises;
• scheduled medical examinations.

Pseudomonas aeruginosa is not only often found in nature, but also lives in the human body. However, in the presence of a larger than usual number of bacteria or a decrease in the level of immunity, it becomes possible for various kinds of ailments to appear.

The overall picture of the disease varies - everything depends on which organ is affected. Treatment should be carried out strictly under the supervision of a doctor, but attempts to recover on their own can lead to complications or even death.

Treatment of Pseudomonas aeruginosa with antibiotics

In any case, you will need to take antibiotics for complex treatment. But before starting treatment, the doctor will send for analysis, which should determine the causative agent of the disease, as well as its reaction to antibacterial drugs.

Depending on the type of disease and the location of the disease, a person must donate urine, blood or mucus. Antibiotics are usually prescribed, which are injected intravenously, most often into the arm, and then intramuscularly into the fifth point or other part of the arm.

At the same time, the treatment of those parts of the body that are directly affected by Pseudomonas aeruginosa is also carried out. When this bacterium appears in the urine, it is necessary to administer antibiotics and antiseptics through a catheter, but if the mucous membrane or skin is affected, it is worth treating them with sprays and aerosols, as well as treating these areas with special ointments and creams.

Treatment of Pseudomonas aeruginosa in the intestine

Infrequently, Pseudomonas aeruginosa can affect the stomach. The first signs of the disease may be vomiting, pain in the intestines, and rare stools. These symptoms can be confused with the appearance of a bacterium with a simple administration.

But rapid dehydration of the body will still indicate a serious disease caused by Pseudomonas aeruginosa. For treatment, the doctor will prescribe cephalosporin drugs ( Cefepime, Ceftazidime), as well as:

• Meropenem;
• imepenem;
• Ciprofloxacin;
• Amikacin.

Treatment of Pseudomonas aeruginosa in the ear

This infection can also affect the ears. The bacterium can cause various types of otitis media. But, in addition to pain in the ear, there will also be various purulent or bloody discharge. Antiseptics and penicillin antibiotics of the fifth and sixth generation are used to fight the infection. Among the drugs that are most often prescribed are the following:

• Cefzulodin;
• Ceftazidime;
• Carbenicillin.

In case of inflammation of the ear, when purulent discharge appears, a turunda is used, lubricated with Bacteriophage, a drug that can destroy bacteria by dissolving. Such turundas are inserted into the ear several times a day for 1 hour.

Treatment of fistulas with Pseudomonas aeruginosa

With the appearance of fistulas caused by Pseudomonas aeruginosa, antibiotic injections are prescribed in the affected area. Especially often they began to use Aspergin, a biological antibiotic that fights not only Pseudomonas aeruginosa, but also destroys some other pathogenic microorganisms.

Treatment of Pseudomonas aeruginosa with folk remedies

If the manifestations of the disease are not too acute, you can use folk methods and remedies for treatment. It would be nice to use a complex of folk remedies, supplemented with antibiotics. The most noticeable effect on the bacterium is decoctions of wild rose, horsetail, viburnum and others. To prepare a medicinal decoction, you must:

Pour a tablespoon of herbs or berries with boiling water, then after cooling, heat in a water bath, and then dilute the concentrate with boiled water (0.5 liters). The drug is taken half a cup several times a day.

Plantain, which is commonly used for wounds, can also help treat Pseudomonas aeruginosa. It is enough to squeeze the juice from its leaves.

At home, for local treatment, a 1-2% solution of boric acid is used to rinse the mouth and throat, wash the eyes, auricles or canals.

Photo: Wikipedia Pseudomonas aeruginosa: symptoms and treatment Pseudomonas aeruginosa is a genus of gram-negative aerobic non-spore-forming bacteria - Pseudomonas. Pseudomonas aeruginosa causes only minor symptoms in many people. However, if a person has a weakened immune system, the threat can be very serious and life-threatening.

Pseudomonas aeruginosa - microbiology

Pseudomonas (Pseudomonas) is a common genus of bacteria that can cause infections in the body under certain circumstances. There are many different types of Pseudomonas bacteria. Only a few types can cause infection.

Pseudomonas tend to live and breed in water, soil, and wet areas. The warmer and wetter the better the conditions for bacteria to thrive.

Surgery or open wounds can increase the risk of infection. People with weakened immune systems are also susceptible to severe Pseudomonas infections.

Pseudomonas aeruginosa can cause ear and skin infections, especially after exposure to water.

There are certain groups of people who are vulnerable to Pseudomonas infections. These include people:

with burn wounds;

undergoing surgery;

using a catheter;

undergoing chemotherapy;

having diabetes;

diagnosed with cystic fibrosis;

Pseudomonas aeruginosa - symptoms

The areas of the body that are affected by the infection are the ears, skin, lungs, soft tissues, and blood. Common symptoms of an infection include:

Ears - pain, itching and discharge from the ear;

Skin - rash;

Eyes - pain and redness;

Lungs: pneumonia, cough;

Soft tissue - discharge of green pus and a sweet fruity odor;

Blood - pain and stiffness of the joints, fever, chills and weakness;

Other possible symptoms are headache, diarrhea, or a urinary tract infection.

Pseudomonas aeruginosa - diagnosis

To diagnose a Pseudomonas infection, the doctor will ask about any recent activities that may be relevant, such as swimming or taking a hot bath. He will also conduct a physical examination. The doctor will order a blood or fluid test to confirm the diagnosis.

Pseudomonas aeruginosa - treatment

Antibiotics are the best treatment for Pseudomonas or other bacterial infections.

Some varieties of Pseudomonas require an aggressive approach with powerful drugs. The sooner treatment begins, the more effective it is to stop the infection. This is especially true in the hospital environment. Bacteria in hospitals are regularly exposed to antibiotics and eventually develop resistance to these drugs. This makes treatment difficult.

Once doctors determine which type of Pseudomonas bacteria is causing the infection, the doctor will combine drugs to make the treatment effective. Most Pseudomonas infections resolve without treatment or with minimal treatment. If the symptoms are not complicated, there is no need to treat the infection.

Description of the infection

Pseudomonas aeruginosa is a very dangerous infection caused by aerobic microbes. Once in the body, they affect the internal organs, muscles, skin, and worst of all - the central nervous system and certain parts of the brain. These harmful microbes live in colonies in the external environment. For humans, the products of their vital activity are dangerous. They are toxic and cause poisoning. For example, these include endotoxins and endohemolysins, which affect

walls of blood vessels that disrupt blood circulation and liver function. They also destroy white blood cells. These microbes are not afraid of traditional antibiotics and antiseptics.

How can you get infected

Pseudomonas aeruginosa lives in the bodies of people and animals. They are basically the main sources of infection. Everything happens the same way as with other intestinal infections. It is transmitted in everyday life through household items, by airborne droplets, if the patient's lungs are affected, by direct contact, if there are purulent wounds. Pseudomonas aeruginosa waits its time in water and soil. It gets there directly from sick people or animals, as well as due to sewage or defective sewers. This infection is also referred to as hospital infections, since it is not uncommon for medical instruments or blood transfusion materials to become the source of the disease. Cases of mass infection of patients of several clinics are known. The pathogen can enter the body through the mouth, mucous membranes, urinary tract, and open wounds.

Signs of illness

Pseudomonas aeruginosa is very dangerous because young children are the main victims. Particularly susceptible to it are infants, weakened and premature. It's easy prey for infection. The onset of the disease is usually rapid, but it can also be slow. The disease begins with a general deterioration in well-being, an increase in temperature to 39-40 degrees. Vomiting, loose green stools appear, with a sharp unpleasant odor, sometimes with streaks of blood. The baby's tummy will be swollen, touching it is painful. Parents should suspect that this is Pseudomonas aeruginosa. Treatment with folk remedies is not carried out. Only in a hospital, only under the supervision of a doctor! If the treatment is delayed, internal bleeding may occur, and this threatens the death of the baby. In addition, the infection leaves behind serious complications. If you explain

figuratively, the bacteria destroy the organ where they got. For example, ulcers appear throughout the small intestine, pneumonia and other disorders of the lungs (up to respiratory arrest), loss of vision, meningitis, sepsis, and so on.

Disease prevention

Pseudomonas aeruginosa is a very terrible disease. The task of parents is to protect babies from infection. The main rule - try to allow less strangers to the baby. The baby does not need to contact with strangers. After all, people can be carriers of anything without knowing it. Strictly observe your hygiene. If you are in a hospital, do not be too lazy to ask how the instruments are sterilized. Insist that most of them be disposable.