Emergence of antibiotic resistance Pseudomonas aeruginosa in intensive care unit; a critical review

Abstract

The emergence of antibiotic resistant bacteria in the healthcare is a serious concern. In the Healthcare premises precisely intensive care unit are major sources of microbial diversity. Recent findings have demonstrated not only microbial diversity but also drug resistant microbes largely habitat in ICU. Pseudomonas aeruginosa found as a part of normal intestinal flora and a significant pathogen responsible for wide range of ICU acquired infection in critically ill patients. Nosocomial infection associated with this organism including gastrointestinal infection, urinary tract infections and blood stream infection. Infection caused by this organism are difficult to treat because of the presence of its innate resistance to many antibiotics (β-lactam and penem group of antibiotics), and its ability to acquire further resistance mechanism to multiple class of antibiotics, including Beta-lactams, aminoglycosides and fluoroquinolones. In the molecular evolution microbes adopted several mechanism to maintain genomic plasticity. The tool microbe use for its survival is mainly biofilm formation, quorum sensing, and horizontal gene transfer and enzyme promiscuity. Such genomic plasticity provide an ideal habitat to grow and survive in hearse environment mainly antibiotics pressure. This review focus on infection caused by Pseudomonas aeruginosa , its mechanisms of resistance and available treatment options. The present study provides a systemic review on major source of Pseudomonas aeruginosa in ICU. Further, study also emphasizes virulence gene/s associated with Pseudomonas aeruginosa genome for extended drug resistance. Study gives detailed overview of antibiotic drug resistance mechanism.

Clinical Relevance of Antibiotic Susceptibility Profiles for Screening Gram-negative Microorganisms Resistant to Beta-Lactam Antibiotics

“…No significant differences were found for the other enzyme groups. The resistance profile observed for these carbapenemase-producing Pseudomonas underscores the critical clinical importance of these microorganisms, because their presence (frequent in intensive care units) requires the use of antibiotics of last resort, e.g., colistin [ 40 , 41 ].…”

Comparison of outer membrane vesicles of three different isolates from Pseudomonas aeruginosa

“…Identification of active components of PA secreting OMVs and its potential therapeutic use remain to be investigated. Infections caused by PA are increasingly difficult to be cured due to the emergence of multiple-drug resistant isolates [26]. Moreover, further researches are necessary to elucidate the safety, efficacy, practicality and mechanisms of action of PA OMVs in therapeutic and preventive clinical practices, especially as vaccine delivery vehicles.…”

Extended spectrum beta lactamase producing bacteria among outpatients with ear infection at FelegeHiwot Referral Hospital, North West Ethiopia

“…Biofilms which are firmly adhered to the damaged tissue of middle ear mucosa are impermeable to antibiotics [35]. Besides, its intrinsic and acquired resistance via outer membrane impermeability, the presence of numerous genes coding resistance to different classes of antibiotics contributes this high resistance rate in P. aeruginosa [37]. Moreover, the high rate of P. mirabilis resistance to ampicillin (93%) in the current study is also consistent with reports from Bahir Dar (87.8%) [3], Mekelle (64%) [12] and Tanzania (100%) [19].…”