Pseudomonas aeruginosa (P. aeruginosa) is a gram-negative, rod-shaped aerobic bacterium. It is a primary cause of hospital-acquired infections. P. aeruginosa is primarily a nosocomial pathogen. It also acts as an opportunistic pathogen, which can only infect a host that is immunocompromised, due to an underlying disease or medication. Although, P. aeruginosa can cause damage to virtually any tissue in the body, it almost never affects the tissues of healthy individuals. It is a problematic pathogen in hospitals; infecting individuals with cancer, burn wound, catheters and cystic fibrosis. P. aeruginosa is most recognized for its resistance to a wide range of antibiotics. In its planktonic form, P. aeruginosa has been found to have many virulence factors. However, P. aeruginosa within biofilms have been found to have a resistance to antibiotics 1,000 times greater than that of its planktonic counterparts [4]. Infections that are caused by bacterial biofilms are very persistent and very difficult to treat.
Biofilms have been partially linked to the persistence of P. aeruginosa in Cystic fibrosis (CF) infections. In recent years, several methods of treatment have been developed, to prevent chronic P. aeruginosa biofilm infections. As a result of these methods, chronic P. aeruginosa infections that were once very common in CF children are rarely contracted in childhood and are more predominant in CF adults [5].
INTRODUCTION
P. aeruginosa is a nosocomial opportunistic pathogen that is highly resistant to antimicrobial agents. It is closely associated medical conditions such as periodontal disease, osteomyelitis and cystic fibrosis.
The resistance to many antibiotics is a well-known property of bacterial biofilms. Biofilms are dense...
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..., as chronic P. aeruginosa infections that were once prevalent in CF children, no longer infect most CF patients during childhood.
Treatment of chronic P. aeruginosa infections in CF lungs
Chronic suppressive antibiotic therapy is the recommended treatment of chronic P. aeruginosa infections in CF airways. This method of treatment consists of the daily use of nebulized tobramycin or colistin for the remainder of the patient’s life, along with a combination therapy consisting of two antibiotics, administered intravenously, every three months for two weeks[6]. Moreover, azithromycin as well as DNase are taken daily. Since chronic suppressive antibiotic therapy has proven to extend the life of CF patients and delay the weakening of pulmonary functions, some aspects of this therapy are steadily being used in biofilm infection treatment in other areas of the body.[6]
Hospital-acquired infections (HAI) are preventable and pose a threat to hospitals and patients; increasing the cost, nominally and physically, for both. Pneumonia makes up approximately 15% of all HAI and is the leading cause of nosocomial deaths. Pneumonia is most frequently caused by bacterial microorganisms reaching the lungs by way of aspiration, inhalation or the hematogenous spread of a primary infection. There are two categories of Hospital-Acquired Pneumonia (HAP); Health-Care Associated Pneumonia (HCAP) and Ventilator-associated pneumonia (VAP).
Accurso (1997) found that at birth the lungs of CF babies are normal but soon, many become infected with bacteria. This bacterial infections cause chest exacerbations in the patients. A 14-day course of intravenous antibiotics is usually given to the patients (CF Trust, 2011). CF patients constantly seek medical attention for various reasons and in most cases, because of the exacerbations. However, hospital-based care is not always favoured by the patients, as it is disruptive for them and their families, taking patients away daily, work activities and social lives for considerable amounts of time (Sequeiros and Jarad 2009). Both consultants and physiotherapist encourage less interruptive patient-administered homecare....
However, increasing antibiotic resistance patterns among intensive care unit pathogens, cultivated by empiric-broad spectrum antibiotic regimens, characterizes the variable concerns. Recent literature point that antibiotic use before the development of VAP is associated with increased risk for potentially resistant gran-negative infections and Methcillin-resistant Staphylococcus auereus (MRSA)
Acinetobacter baumannii are aerobic and non-fermentative, gram-negative bacteria [6]. This bacterium is an opportunistic pathogen found in soil and water. Also, it is commonly isolated from the hospital environment and hospitalized patients; therefore, it is known to cause nosocomial infections [6,9]. In addition, this bacterium has the ability to adhesion and forming biofilms on abiotic surfaces as well as the ability of secretion of the exopolysaccharide (EPS) a substance that allows the binding of bacterial cells to the surface, and with each other [6,9]. Further more, this bacterium capable of developing a new resistance to antibiotics by several mechanisms such as inhibiting the 30S ribosomal subunit, mutations, or Efflux
My disease is Streptococcal pneumonia or pneumonia is caused by the pathogen Streptococcus pneumoniae. Streptococcus pneumoniae is present in human’s normal flora, which normally doesn’t cause any problems or diseases. Sometimes though when the numbers get too low it can cause diseases or upper respiratory tract problems or infections (Todar, 2008-2012). Pneumonia caused by this pathogen has four stages. The first one is where the lungs fill with fluid. The second stage causes neutrophils and red blood cells to come to the area which are attracted by the pathogen. The third stage has the neutrophils stuffed into the alveoli in the lungs causing little bacteria to be left over. The fourth stage of this disease the remaining residue in the lungs are take out by the macrophages. Aside from these steps pneumonia follows, if the disease should persist further, it can get into the blood causing a systemic reaction resulting in the whole body being affected (Ballough). Some signs and symptoms of this disease are, “fever, malaise, cough, pleuritic chest pain, purulent or blood-tinged sputum” (Henry, 2013). Streptococcal pneumonia is spread through person-to-person contact through aerosol droplets affecting the respiratory tract causing it to get into the human body (Henry, 2013).
Breidenstein, Elena BM, César de la Fuente-Núñez, and Robert EW Hancock. "Pseudomonas aeruginosa: all roads lead to resistance." Trends in microbiology 19.8 (2011): 419-426.
“Cystic Fibrosis in Adults: From Researcher to Practitioner” written by Gregory P. Marelich and Carroll E. Cross discusses the in depth details of cystic fibrosis. Gregory Marelich is a Doctor of Medicine (M.D.) and has certifications in internal medicine, pulmonary disease, and critical care medicine. Carroll Cross is a Doctor of Medicine and a Bachelor of Arts (B.A.). She is certified in pulmonary disease and internal medicine. Both authors have experience working in multiple facilities in California and have a sufficient amount of knowledge to write articles pertaining to pulmonary or medical conditions. Throughout the article they exhibit their knowledge and understanding for the lung disease cystic fibrosis.
The role of nurses in the prevention of MRSA in the hospitals cannot be overemphasized. The prevalence of MRSA in hospitals calls for awareness and sensitization of all party involved in patient caregiving in the hospital. According to Wilkinson and Treas (2011), nurses take on many roles in the hospital: a caregiver, advocate, communicator, leader, manager counsellor, change agent and an educator. (Wilkinson &Treas. (2011) p.13.) The target of healthy people 2020 is to reduce MRSA and all other hospital acquired infection by 75% in the year 2020. (Healthy people 2020) This cannot be achieved without the maximum support of nurses because nurses have regular one on one contact with patients on daily basis.This paper will take a closer look at the role of a nurse as an educator in the prevention of MRSA in the hospital. One of the nurse’s roles in the prevention of MRSA in hospitals is patient/visitor/staff education.
Streptococcus pneumoniae is a Gram-positive and fast-growing bacteria which inhabit upper respiratory tract in humans. Moreover, it is an aerotolerant anaerobe and usually causes respiratory diseases including pneumonia, otitis media, meningitis, peritonitis, paranasal sinusitis, septic arthritis, and osteomyelitis (Todar, 2003). According to Tettelin et al., more than 3 million of children die from meningitis or pneumonia worldwide (2001). S.pneumoniae has an enzyme known as autolysin that is responsible for disintegration and disruption of epithelial cells. Furthermore, S.pneumoniae has many essential virulence factors like capsule which is made up of polysaccharides that avoids complement C3b opsonization of cells by phagocytes. Many vaccines contain different capsular antigens which were isolated from various strains (Todar, 2003). There are plenty of S.pneumoniae strains that developed resistance to most popular antibiotics like macrolides, fluoroquinolones, and penicillin since 1990 (Tettelin et al., 2001). Antibiotic resistance was developed by the gene mutation and selection processes that, as a consequence, lead to the formation of penicillin-binding proteins, etc. (Todar, 2003).
Bacterial resistance to antibiotics has presented many problems in our society, including an increased chance of fatality due to infections that could have otherwise been treated with success. Antibiotics are used to treat bacterial infections, but overexposure to these drugs give the bacteria more opportunities to mutate, forming resistant strains. Through natural selection, those few mutated bacteria are able to survive treatments of antibiotics and then pass on their genes to other bacterial cells through lateral gene transfer (Zhaxybayeva, 2011). Once resistance builds in one patient, it is possible for the strain to be transmitted to others through improper hygiene and failure to isolate patients in hospitals.
Antibiotic resistance occurs in bacteria when the use of antibiotics manages to kill off every bacteria except for a lone few. The lone few then live to pass on their DNA every time they undergo binary fission and the antibiotic resistance bacteria spread. This antibiotic resistance has given rise to numerous problems in the medical world as the bacteria they used to handle with a prescription of antibiotics now thrive without barriers. Currently, the main six bacteria that present problems with antibiotic resistance are Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp., collectively known as the ESKAPE pathogens. Collectively these ESKAPE pathogens claim
Biofilms can form on many surfaces, including natural aquatic systems, human teeth, medical devices like artificial heart valves and catheters,
Biofilms are formed by a six step process. First is a reversible process, when an organic monolayer(made of polysaccharides or glycoproteins) absorbs to the surface, altering the chemical and physical properties of the surface. This makes the surface more conditioned and increase the chance that planktonic bacteria will attach. Secondly, also a reversible step, is when the free-floating or planktonic bacteria encounter the conditioned surface, and some attachment of the bacteria may occur. The third step is when the bacteria is left attached too long, then an irreversible attachment occurs. F...
However, as antibiotics have been overused, underused and misused in treating bacteria as well as viruses (which antibiotics do not have an effect on), bacteria have begun to fight back and some have altered their DNA to become harder to treat with antibiotics. When this happens, bacteria are no longer sensitive to this medication that would have on...
Greenwood, D., Slack, R., Peutherer, J. and Barer, M. (2007) Medical Microbiology, the United States: Elsevier.