Pseudomonas aeruginosa in tracheal aspirate: Colonization, infection, and recurrence

Abstract

Introduction Pseudomonas aeruginosa respiratory infections are challenging, and the risk of recurrence is a frequent problem. The aim of this study was to investigate the risk factors associated with the presence of P. aeruginosa, and the risk factors related to the recurrence and death of lower airway infections in inpatients in a Brazilian hospital. Methods Retrospective cohort with inpatients that had a sample of airways culture (tracheal aspirate or bronchoalveolar lavage) with the detection of P. aeruginosa. The patients with clinical criteria of infection were classified as ventilator‐associated, hospital‐acquired, or community‐acquired pneumonia. P. aeruginosa in respiratory samples without symptoms was considered colonization. The antimicrobial treatment adequacy and the clinical data were evaluated. Outcome variables included mortality and recurrence. Results One hundred and fifty‐four patients were included in the study, most of them were men, and the majority (102) were considered infected. The average length of stay was superior to 30 days. Previous pulmonary disease was associated with the occurrence of colonization. Aminoglycosides were the most active drug according to susceptibility tests and were successfully used as monotherapy. Septic shock was a risk factor for death in the infected patients. The use of adequate antimicrobial therapy was associated with major survival, independent of the infection classification. Conclusion It is possible to evaluate clinical data associated with recurrence and mortality in patients with different lung infections by P. aeruginosa. Aminoglycoside monotherapy is safe and effective in P. aeruginosa respiratory infections.

The impact of quantitative and semi-quantitative culture of respiratory tract secretions on clinical decisions in a patient with suspected pneumonia – case study

“…PN 1 includes BAL with a threshold level of ≥10 4 CFU/ml or PSB with a threshold level of ≥10 3 CFU/ml, PN 2 includes TA with a threshold level of ≥10 (20) . Prolonged hospital stay, antibiotic use and severity of illness are thought to increase the risk of Pseudomonas aeruginosa colonization (21) . P. aeruginosa is an opportunistic pathogen that has the ability to acquire antibiotic resistance and form antibioticresistant biofilms, which can cause many therapeutic problems (22) .…”

“…Pseudomonas aeruginosa usually causes respiratory and urinary tract infections, burn wound infections, meningitis and sepsis (17) . It is also worth mentioning that tracheal colonization by P. aeruginosa increases the risk of VAP eight times (21).…”

Ocorrência de genes de resistência metalo-beta-lactamases em isolados de Pseudomonas aeruginosa MDR de otites de cão, Brasil

“…A Pseudomonas aeruginosa é uma bactéria oportunista, considerada um dos principais agentes de infecção nosocomial em hospitais associada múltipla resistência a antibacterianos (CARVALHO et al, 2013;SILVA JÚNIOR et al, 2014;ROCHA et al, 2019), sendo apontada como um problema de saúde pública (NUNES et al, 2023). Em animais, principalmente cães, este microrganismo está associado a otite sendo relatados ocorrência de P. aeruginosa multirresistentes (MDR) a antibióticos envolvidos (ARIAS et al, 2017).…”