Pseudomonas

Cards (94)

  • Objectives related to Pseudomonads
    • Know their general characteristics
    • Understand the characteristics, virulence factors and pathogenesis of infection caused by those organisms
    • Know the various methods for laboratory diagnosis of infections
    • Know the general principles of treatment, prevention and control of infection they caused
  • Pseudomonas aeruginosa
    • Commonly present in moist environments in hospitals
    • Saprophytes causing disease in humans with abnormal host defense, especially in neutropenia
    • Gram negative, Motile, Rod-shaped occurring singly, in pairs, and occasionally in short chains
    • Obligate aerobe
    • Produces a sweet or grape-like or corn taco-like odor
    • Forms smooth round colonies with fluorescent greenish color
    • Forms mucoid colonies in patients with Cystic fibrosis due to overproduction of Alginate, an exopolysaccharide
    • Grows well at 37-42°C; oxidase positive
    • Does not ferment carbohydrates
  • Pathogenesis of Pseudomonas aeruginosa
    1. Pathogenic if introduced into areas devoid of normal defenses, attaches and colonizes mucus membrane, invades locally, produces systemic disease
    2. Lipopolysaccharide plays a direct role in causing various symptoms
    3. Propensity to form biofilms in catheters greatly contributes to virulence
  • Diagnostic Laboratory test for Pseudomonas aeruginosa
    Specimens obtained from various sources, Gram-negative rods seen, cultures in blood agar for specific diagnosis
  • Pseudomonads
    • Gram negative, motile, aerobic rods
    • Produce water-soluble pigments
    • Classification based on rRNA/DNA homology and common culture characteristics
  • Antigenic structures and toxins of Pseudomonas aeruginosa
    • Pili (fimbriae)
    • Exopolysaccharide, alginate
    • Enzymes like elastases, proteases, and two hemolysins
    • Exotoxin A
    • Exoenzymes S and T
    • Exoenzyme U
    • Exoenzyme Y
  • Clinical findings of Pseudomonas aeruginosa infection
    • Infection of wounds and burns with blue-green pus
    • Meningitis introduced by lumbar puncture or during neurosurgical procedure
    • UTI introduced by catheters
    • Necrotizing pneumonia from contaminated respirators
    • Otitis externa among swimmers and invasive otitis externa in patients with diabetes
    • Ecthyma gangrenosum with skin necrosis often in sepsis
  • Brucellae are obligate parasites
  • Brucella canis infects dogs
  • Brucella suis infects swine
  • Brucellae are Gram-negative but stain irregularly
  • P. aeruginosa causes mucoid colonies due to the formation of Alginate
  • Brucellae have preferred hosts and can infect through ingestion, mucous membranes, and skin contact
  • Erythritol is a growth factor for brucellae found in placenta and fetal membranes except in humans
  • Brucellae are tiny gram-negative coccobacilli that are catalase positive and oxidase positive
  • Brucellae produce small, convex, smooth colonies on enriched media in 2-5 days
  • Cultures in blood agar are the specific test for diagnosis of P. aeruginosa infection
  • Brucella melitensis infects goats and has multiple biovars
  • P. aeruginosa infection can lead to Cystic Fibrosis
  • Brucellosis, also known as Undulant fever or Malta fever, is a disease in humans characterized by an acute bacteremic phase followed by a chronic stage
  • Brucellae cause different clinical findings depending on the species
  • Brucella abortus infects cattle
  • Brucellae are moderately sensitive to heat and acidity and are killed in milk pasteurization
  • Brucellae are aerobic, non-motile, and non-spore forming
  • Brucellae can be diagnosed through blood culture, biopsy material culture, and serum testing
  • Specimens where organisms are most often isolated
    • Bone marrow
    • Blood
  • Serology
    1. IgM antibody levels rise during the first week of acute illness, peak at 3 months, persists during chronic disease
    2. IgG rise after 3 weeks of onset, peak 6-8 weeks, remain high during chronic disease
  • Agglutination test – IgG agglutinin titers above 1:80 indicate active infection
  • Combined treatment with tetracycline and either streptomycin or gentamycin for 2-3 weeks or rifampicin for 6-8 weeks is recommended
  • Limitation of spread and possible eradication of animal infection, pasteurization of milk and milk products, and reduction of occupational hazards wherever possible
  • Brucellacapt– rapid ELISA – IgG, IgA, and IgM antibodies are detected
  • Specimens where Francisella tularensis may be recovered
    • Lymph node aspirates
    • Bone marrow
    • Peripheral blood
    • Deep tissue
    • Ulcer biopsies
  • Biosafety practices are required
  • Penetration of the skin or mucous membranes or inhalation of 50 organisms can result in infection
  • Treatment options for Brucella species
    • Tetracyclines
    • Rifampicin
    • Trimethoprim sulfamethoxazole
    • Aminoglycosides
    • Some quinolones
  • Yersinia and Pasteurella
    Short, pleomorphic Gram-negative rods that can exhibit bipolar staining
  • Streptomycin or Gentamycin for 10 days; resistant to all beta-lactam antibiotics due to beta-lactamase production
  • Brucella species

    • Tiny gram-negative coccobacilli that are catalase positive and oxidase positive
    • A positive urease test is characteristic
  • In patients with endocarditis or evidence of neurological disease, triple therapy with doxycycline, rifampicin, and an aminoglycoside is suggested
  • For best results, treatment must be prolonged