Kingdom: Bacteria Phylum: Proteobacteria Class: Gamma Proteobacteria Order: Pseudomonadales Family: Pseudomonadadaceae Genus: Pseudomonas Species: aeruginosa

Pseudomonas
Pseudomonas aeruginosa
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Pseudomonas aeruginosa
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 Gram-negative rod, motile, free-living bacterium. Aerobic Oxidase (+), non fermenter , Catalase (+) Wont require any nutrients for its growth, Grow in distilled water Resistant to high temperatures 420C Resistant to salts and dyes, weak antiseptics, and many commonly used antibiotics. two soluble pigments, the pyoverdin -fluorescent pigment and pyocyanin - blue pigment. antibiotic resistance - Transduction and conjugation hemolytic fruity odor
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Virulent Factors Colonization

Pili:
Galactose or mannose or sialic acid receptors of Host cells Protease cleaves fibronectin

Exopolysaccharide (alginate):
Mannuronic and glucuronic acid Alginate Seen in Mucoid strains - Cystic fibrosis - Biofilm Inhibits lymphocytes, phagocytes, the Ciliary action of the respiratory tract, antibodies, complement, and antibiotic action

Exoenzyme S:
Glycolipid receptors on respiratory cells
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Invasion
Elastase:
cleaves collagen, IgG, IgA, and complement Degrades Fibronectin on mucosa Disrupts cilia and respiratory epithelium

Alkaline protease:
interferes with fibrin formation and degrades fibrin

Both these enzymes distrust cornea and Inf and TNF.

Cytotoxin:
Pore forming toxin, majorly effects neutrophils, and toxic to all cells.

Hemolysins ( Phospholipase & lecithinase):

break down lipids and lecithin
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Pigments:
Pyocyanin: Blue
It is an effective antibiotic against Staph Aureus, thus it overtakes Staph in CF
lung infections.

Pyoverdin: florescence
Helps to acquire iron. Ciliostatic.

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Dissemination:
Toxins: Endotoxin: LPS Exoenzyme S (AB toxin) :
Impairs protein synthesis by ADP-ribosylating activity to many cells. And inhibits activity of phagocytes. It is widely seen in Burns patients.

Exotoxin A (AB-Toxin):
similar to Diphtheria toxin, toxic to liver cells

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Epidemiology
Ubiquitous Soil, water and air 3-4 % non hospitalized patients have Skin and GIT Opportunistic Pathogen Hospitals - Disinfectants, Respiratory Equipment, Food, Sinks, Taps, Toilets, Showers And Mops Hospitals Gets Organisms By Fruits, Vegetables And Visitors. Common cause of Hot Tub folliculitis, 3rd most common cause of UTI Common cause of bacterial keratitis Predisposing factors:
Immune compromised, burns, Hospital, cancer pts, cystic fibrosis
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Pathogenesis
Pseudomonas B.V Adhesion: Pili Polysaccharide Capsule (Glycocalyx) Alginate Slime (Biofilm)

Invasins

Invasins: Elastase Alkaline Protease Hemolysins Cytotoxin (Leukocidin) Pyocyanin Pigment

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Pathogenesis
Pseudomonas B.V

Adhesion: Pili Polysaccharide Capsule (Glycocalyx) Alginate Slime (Biofilm)

Invasins: Elastase Alkaline Protease Hemolysins Cytotoxin (Leukocidin) Pyocyanin Pigment

Invasins

Toxins

Dissemination: Exoenzyme S Exotoxin A Lipopolysaccharide

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Clinical Conditions
Pneumonia Endo carditis CNS infections UTI External ear infections (External Otitis) GIT infections Eye infections Skin infections (erythema gangrenosum) Bone and Joint infections
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Erythema Gangrenosum

Diagnosis
Gram Negative bacilli. Motile Non fermenter Non lactose Oxidase Positive Beta hemolytic with Blue green colonies Fruity odor

Aerobic
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Courtesy by Dr. Kenneth todar.

Treatment
Resistant to antibiotics Gentamicin, Tobramycin, Colistin, And Fluoroquinolins Gentamicin And Carbenicillin Is Frequently Used Prevention:
Isolation procedures, aseptic technique, and careful cleaning and monitoring of respirators, catheters, and other instruments silver sulfadiazine, coupled with surgical debridement reduce the incidence in Burns pts

Dr.Aravind