Pseudomonas. Clinical problems related to virulence factors and development of resistance

Abstract

P. aeruginosa has emerged into the limelight mainly as a result of compromised host problems and the development of resistance leading to serious treatment difficulties. The organism possesses virulence factors that produce an effect in certain clinical (human) situations. Changes in local anatomy, often with the presence of foreign bodies, are important (bladder and i.v. catheters, tracheostomy, burns, wounds and injuries). Deficiencies in immune defense, particularly granulocytopenia, are almost a prerequisite for development of Pseudomonase septicemia and meningitis. The toxic factors of Pseudomonas organisms in combination with a disturbed defense mechanism produce characteristic necrotic skin lesions. A mucoid form of P. aeruginosa is a characteristic feature of cystic fibrosis. Resistance of P. aeruginosa to antibiotics is very definitely associated with overuse of broad-spectrum antibiotics in hospitals. New and more effective antibiotics may be needed.