Journal of Medicine and Medical Sciences

Abstract

Gram-negative pathogen Pseudomonas aeruginosa has emerged as a significant human infection that can be associated with significant morbidity and mortality. Immuno compromised patients or those with chronic, debilitating conditions typically suffer from severe infections. Its ability to adapt to a wide range of environments, virulence factors, and antibiotic resistance increase its significance as a pathogen. P. aeruginosa can exhibit multiple acquired or intrinsic resistance mechanisms, frequently exhibiting high rates of resistance to various antimicrobial classes. The so-called "high-risk clones" of P. aeruginosa that are multidrug-resistant or extensively drug-resistant have become a public health threat in recent years and require urgent and determined research and management. One of the most prevalent Gram-negative bacteria that causes nosocomial and healthcareassociated infections in hospitalized patients is P. aeruginosa. Hand hygiene (with the appropriate use of alcoholbased solutions), contact precautions, patient isolation (single room or cohort), environmental cleanliness, and surveillance should all be implemented in healthcare facilities to prevent the spread of multi resistant P. aeruginosa.

Keywords

P. aeruginosa, Gram-negative, Pathogen, Healthcare, Environment

INTRODUCTION

Gram-negative pathogen Pseudomonas aeruginosa has emerged as a significant human infection that can be associated with significant morbidity and mortality. One of the most common and severe causes of hospital-acquired infections is this microorganism, particularly affecting immunocompromised (particularly neutropenic) patients and ICU patients. The majority of P. aeruginosa strains are resistant to the majority of commonly used antibiotics. P. aeruginosa infections can be life-threatening and are emerging as a global public health threat due to a variety of adaptation, survival, and antibiotic resistance mechanisms. The purpose of this narrative review is to describe the infectious risk posed by P. aeruginosa in healthcare facilities. PubMed.gov and Scopus were searched for published papers on the bacteriology, ecology, reservoir, infection, and prevention and control of P. aeruginosa in healthcare.

DISCUSSION

Infections of Pseudomonas aeruginosa

Infections caused by P. aeruginosa are uncommon in healthy individuals and typically mild. For instance, skin infections acquired in swimming pools are short-lived and self-limiting. Patients with compromised immune systems or those with chronic, debilitating conditions typically suffer from severe infections. In most cases, the outcome of a P. aeruginosa infection is determined by the patient's overall health and condition. Its ability to adapt to a wide range of environments, virulence factors, and antibiotic resistance increase its significance as a pathogen. Patients with carbapenem-resistant and extensive -lactam-resistant P. aeruginosa infections are more likely to delay receiving the appropriate antibiotic treatment, which can lead to prolonged hospitalization, an increased risk of subsequent infections that are resistant to antibiotics, as well as morbidity and mortality (de Jonge P et al., 2018) (Park C et al., 2013).

The bacteria have a huge advantage when it comes to infecting susceptible hosts because they can form biofilms. P. aeruginosa biofilms found in the lungs of people with CF are one type of biofilm-related infection that is of particular medical concern. P. aeruginosa in the airways of CF patients causes chronic infections that typically last for an indefinite amount of time once they are established. 60-80% of adults will eventually contract P. aeruginosa on a regular basis. Acquisition of P. aeruginosa is a significant contributor to the onset and progression of CF respiratory disease and is linked to increased morbidity and mortality in CF patients. Malignant blood cancers, neutropenia following immunosuppressive therapy, bacteremia pneumonia, and other conditions are also thought to increase the risk. In a similar manner, prolonged venous or urinary catheterization, invasive surgical procedures, severe burns, and wounds permit the microorganism to enter the various tissues and colonize them; Septicaemia can result from this (Sarris J et al., 2014) (Liem A et al., 2017) (Vohra S et al,. 2005)

Pathogens that are responsible for infections that are linked to healthcare, such as P. aeruginosa, are frequently present in water sources and devices that are related to water. This could occur as a result of endpoint contamination or microorganisms surviving treatment protocols. It was reported a clonal multidrug-resistant outbreak of P. aeruginosa in a tertiary care hospital's interdisciplinary surgical intensive care unit. The authors discovered evidence of a transmission route associated with sink-based working procedures, particularly patient grooming (Grace S et al., 2010) (Templeman K et al., 2011).

CONCLUSION

In accordance with WHO guidelines, healthcare facilities should implement at least the following measures to prevent the spread of multiresistant P. aeruginosa Hand hygiene (using alcohol-based solutions appropriately), contact precautions, patient isolation (in a single room or in a group), environmental cleanliness, and surveillance are all important. In order to limit the spread of multiresistant bacteria like P. aeruginosa, the European Centers for Disease Control and Prevention (ECDC) recommends enhancing and expanding screening, preventive isolation, and surveillance in healthcare facilities for patients who have been transferred from or have recently been in contact with such facilities. At the time patients are transferred, having documentation regarding multiresistant P. aeruginosa infection or carrier status would aid in the swift and efficient implementation of measures to prevent the microorganism's spread (Lake J et al., 2012) (Pengpid S et al., 2018).

In order to account for the increased risk of infection and transmission that is associated with ICU-specific working procedures (such as ventilator support and central-line catheters), Intensive Care Units (ICUs) require specific infection prevention measures, which are distinct from standard care wards. In addition, in order to manage waterrelated risk in healthcare facilities, WHO guidelines for the prevention of nosocomial infections by water-borne microorganisms state that a Water Safety Plan (WSP) must be implemented. The essential components of this plan include active monitoring of infections, the adoption of sanitization procedures, maintenance and testing of the water supply, and scheduled testing of water taken from the most significant points in the hospital water system. To ensure that the WSP meets health-based goals and works effectively, validation procedures should be established (Stepleman LM et al., 2015).

ACKNOWLEDGEMENT

None

CONFLICT OF INTEREST

None

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