Pseudomonas aeruginosa nosocomial meningitis in neurosurgical patients with intraventricular catheters: Therapeutic approach and review of the literature

Rodríguez-Lucas, Carlos; Fernández, Javier; Martínez-Sela, María; Álvarez-Vega, Marco; Morán, Noelia; Garcia, Alicia; Menéndez, Candela; García-Prieto, Emilio; Rodríguez-Guardado, Azucena

doi:10.1016/j.eimc.2019.04.003

Cited by 21 publications

(14 citation statements)

References 26 publications

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“…Such pathologies happen in the most cases following neurosurgeries, such as shunt insertions and external ventricular cerebrospinal fluid drainages, which serve as a direct mode of entry for this pathogen [ 422 ]. As is the case for most P. aeruginosa infections, poor outcome is tightly linked to the antibiotic resistance profile of the infecting strain and the timely administration of the antibiotic therapy, with intrathecal injection showing the best outcome with adequate antibiotics [ 11 , 422 ].…”

Section: Brainmentioning

confidence: 99%

“…P. aeruginosa is also known to cause a wide variety of other infections, encompassing all organs of the human body, including soft tissue infection in burns, open wounds and postsurgery; urinary tract infection associated with the use of urinary catheter; foot infection in diabetics and individuals with impaired microvascular circulation; ear infection, especially otitis externa and chronic suppurative otitis media associated with tissue injury and water blockage; and keratitis associated with extended contact lens wear and contaminated contact lens [ 8 ]. Other rarer but serious infections include endocarditis occurring in patients with or without injection drug use [ 9 , 10 ]; and meningitis associated with penetrating trauma to the head, placement of a CNS shunt (such as a ventriculoperitoneal (VP) shunt), or post-neurosurgical procedures [ 10 , 11 ]. Poor antibiotic stewardship in the past few decades has led to emergence and spread of multidrug-resistant strains.…”

Section: Introductionmentioning

confidence: 99%

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An Organ System-Based Synopsis ofPseudomonas aeruginosaVirulence

et al. 2021

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Driven in part by its metabolic versatility, high intrinsic antibiotic resistance, and a large repertoire of virulence factors, Pseudomonas aeruginosa is expertly adapted to thrive in a wide variety of environments, and in the process, making it a notorious opportunistic pathogen. Apart from the extensively studied chronic infection in the lungs of people with cystic fibrosis (CF), P. aeruginosa also causes multiple serious infections encompassing essentially all organs of the human body, among others, lung infection in patients with chronic obstructive pulmonary disease, primary ciliary dyskinesia and ventilator-associated pneumonia; bacteremia and sepsis; soft tissue infection in burns, open wounds and postsurgery patients; urinary tract infection; diabetic foot ulcers; chronic suppurative otitis media and otitis externa; and keratitis associated with extended contact lens use. Although well characterized in the context of CF, pathogenic processes mediated by various P. aeruginosa virulence factors in other organ systems remain poorly understood. In this review, we use an organ system-based approach to provide a synopsis of disease mechanisms exerted by P. aeruginosa virulence determinants that contribute to its success as a versatile pathogen.

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Section: Brainmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An Organ System-Based Synopsis ofPseudomonas aeruginosaVirulence

et al. 2021

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“…As soon as a diagnosis of certain or probable ventriculitis is made the EVD catheter should be removed. Failure to remove the infected EVD catheter was identified as a significant risk for treatment failure and mortality [84]. Once a new EVD catheter has been placed, appropriate antibiotic treatment should begin, and this should be guided by laboratory identification and antibiotic susceptibilities.…”

Section: Evd Infectionsmentioning

confidence: 99%

Infections in CSF Shunts and External Ventricular Drainage

Bayston¹

2022

Cerebrospinal Fluid

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Infection in those with hydrocephalus shunts or external drains (EVDs) can cause serious central nervous system damage with lasting sequelae. The infections usually involve bacterial colonisation and biofilm formation in the catheters. The nature and sources of pathogens and preventive measures are discussed. The risks of infection in shunts and EVDs is different. Infection in shunts is almost always initiated at their insertion or revision (exceptions are described). In contrast, in EVDs, the risk of infection persists throughout their use. The pathogen profile is also different. These factors are important considerations when planning preventive measures. Newer strategies such as antimicrobial catheters are discussed. Diagnosis of EVD infections in an already ill patient is difficult but guidelines can be useful. Treatment of the shunt and EVD infections are also addressed, with reference to modes and routes of antibiotic administration.

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“…Majorly, there is history of neurosurgical procedure in patients who develop P. aeruginosa meningitis [50]. Also, P. aeruginosa neurosurgical meningitis is one of the uncommon entities typically associated to elevated rates or mortality and with intraventricular catheters [51]. Adult bacterial meningitis (ABM) resulted from P. aeruginosa was typically because of nosocomial infections and typically identified in patients experiencing post neurosurgical state [49].…”

Section: P Aeruginosa Associated Meningitismentioning

confidence: 99%

“…Extracellular matrix is vital feature related to biofilm communities, it is surrounding the resident bacteria and it includes matrix proteins, lipid vesicles, exopolysaccharides and extracellular DNA (eDNA), whereas the 3 exopolysaccharides regarding P. aeruginosa biofilm matrix (alginate, Pel and Psl) [55]. Mainly, the biofilm includes bacterial derived exopolysaccharides which is protecting encapsulated bacteria from host immune cells as well as antibiotics [56]. In addition, biofilm are considered to be widespread in their nature and constituting a significant strategy carried out via microorganisms for surviving in often harsh conditions of environment.…”

Section: Biofilm Formation and Antibiotic Resistancementioning

confidence: 99%

Pseudomonas aeruginosa: Diseases, Biofilm and Antibiotic Resistance

Al-Dahmoshi¹,

Al-Obaidi²,

Al-Khafaji³

2021

Pseudomonas Aeruginosa - Biofilm Formation, Infections and Treatments

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Pseudomonas aeruginosa is Gram negative bacteria that can adapt to extreme environmental conditions and withstand to different antibacterial agents. It si responsible for arrays of infections both community and hospital acquired especially ICU infections. Respiratory tract infection, blood stream infection, wound infection, burn infection, and urinary tract infections ware top five P. aeruginosa infections. Additionally as an opportunistic bacteria, it may be associated with healthcare infections in intensive care units (ICUs), ventilator-associated pneumonia (VAP), central line-associated blood stream infections, surgical site infections, otitis media, and keratitis. P. aeruginosa can form biofilms as self-produced extracellular matrix to protects the cells from antibiotics and the host immune response. Antibiotic resistance was an prominent feature of this pathogen and can donate it one of the three resistance patterns: Multidrug (MDR), extensive drug (XDR) and pan drug resistance. It exploit many resistance mechanisms ranged from overexpression of drug efflux systems protein, modifying enzyme production, reducing the permeability and using shelters like biofilms.

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Pseudomonas aeruginosa nosocomial meningitis in neurosurgical patients with intraventricular catheters: Therapeutic approach and review of the literature

Cited by 21 publications

References 26 publications

An Organ System-Based Synopsis ofPseudomonas aeruginosaVirulence

An Organ System-Based Synopsis ofPseudomonas aeruginosaVirulence

Infections in CSF Shunts and External Ventricular Drainage

Pseudomonas aeruginosa: Diseases, Biofilm and Antibiotic Resistance

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