Pseudomonas Aeruginosa Infection Diagnosis And Treatment

Introduction

Overview of pseudomonas aeruginosa 

Pseudomonas aeruginosa is one of the more common types of bacteria that causes infections in people. It is commonly found in water, plants and soil environments, but it can also grow in moist and humid environments, such as sinks and bathtubs. It can also be found on your skin, however it might not cause you an infection.¹

Importance of timely diagnosis and treatment

A P. aeruginosa infection can be serious to those who are immunocompromised and have a weaker immune system caused by:

• Autoimmune conditions - rheumatoid arthritis and lupus
• Cystic fibrosis 
• Cancer
• Diabetes
• AIDS or HIV
• Kidney and Liver disease
• Organ transplants 
• Pregnancy
• Severe burns 
• Sepsis - most common
• Surgery

Because of a weakened immune system, it is important to make sure you are diagnosed and treated fast and appropriately, otherwise you are at risk of serious complications. ^1,2 

Symptoms^1,2

The symptoms vary depending on where infection affects your body. Your symptoms may include:

Blood

• Chills
• Fatigue
• Muscle pain
• Fever
• Joint pain
• Low blood pressure 

Ear

• Earache
• Ear discharge
• Itching
• Swelling
• Hearing loss - rare

Gastrointestinal tract

• Headache
• Diarrhea
• Nausea 
• Vomiting

Eye

• Inflammation
• Pain
• Pus
• Red eyes
• Swelling
• Reduced vision

Lung

• Chills
• Cough
• Breathing difficulties
• Fever
• Phlegm

Skin

• Discoloured bumps-coloured red, purple or brown
• Itchiness.
• White or yellow pus-filled bumps abscess

Urinary tract

• Having to pee suddenly 
• Leaking pee 
• Pain around your pelvic area.
• Pain when peeing 
• Frequent urination

Diagnosis of pseudomonas aeruginosa infection

Diagnostic tests^1,3

Physical examination

Your doctor will first start to look at your medical history  and ask you for any symptoms that you are experiencing and conduct a physical examination:

• Listening to your heart and lungs using a stethoscope
• Feeling your abdomen
• Look at your eyes
• Examine your skin 

 Microbiological cultures

A blood sample or other body fluids sample will be taken and examined, looking at the growth of Pseudomonas aeruginosa.

Imaging studies 

To look at signs of infections in different areas of the body, your doctor will do these tests, including:

• CT scan 
• MRI
• Ultrasound
• X-rays

Factors affecting the treatment approach 

Antibiotic resistance patterns

P.aeruginosa infections are typically the hardest to treat. This is because, over the years the bacteria has evolved and changed its response to treatment, so antibiotics that used to treat these infections, no longer work, causing antibiotic resistance.¹ 

Treatment strategies

Antibiotic therapy

Your doctor, depending on your infection, will prescribe antibiotics, including:

• Aztreonam
• Carbapenems
• Ciprofloxacin
• Ceftazidime
• Gentamicin
• Urreidopenicillins
• Ticarcillin

These can be taken orally, in the form of a pill, cream or through eye drops and intravenously. P.aeruginosa infections are now becoming resistant to the different antibiotics. It is important to finish the course of the antibiotics, even when you feel better, because if not completed the infection can return and become more of a challenge to treat it.^1,5 

Prevention and control measures¹

You can prevent the risk of developing infections through:

• Regular hand washing  with clean water and antibacterial soap 
• Washing fruits and vegetables with clean water
• Thoroughly cleaning surfaces with disinfecting products
• Drinking clean water 
• Avoiding dirty and unclean hot tubs and pools 

Prognosis 

The outlook for a P.aeruginosa infection is good when you have a good immune system, given the right treatment you should clear the infection up in just a few days, but you must finish your entire course of antibiotics. For those with a weaker immune system or those who are immunocompromised, the infection can be severe and might need to take more than one type of antibiotic. As well as taking the treatment for a longer period of time to prevent the worsening of the infection. ^1,2

Future directions in diagnosis and treatment

Novel therapeutic approaches^6,7

With new technology, there is always new hope in terms of treatment especially, because there is always room for improvement. New studies have found phage therapy and immunotherapies to be a new direction to be explored for infections. 

Phage therapy

Since P.aeruginosa is very difficult to control with conventional antibiotics, studies showed phage therapy as an alternative to antibiotics to fight against bacteria. Phage therapy has a lot of advantages because they are quicker to act on the bacteria and it can be used in combination with antibiotic medication. In addition to this, phages can differentiate between the resistant bacteria against the sensitive bacteria, so it can be used as a diagnostic tool. 

Immunotherapies

Immunotherapies have also been shown to be a new way to treat P.aeruginosa, because it uses your own immune system to stop the growth of the bacteria, by changing the immune system to have a better response to the treatment. 

Conclusion

P.aeruginosa is a bacteria that can be found in moist and wet environments, like water and soil. Infections caused by this are usually minor but are more severe when you have a weakened immune system. It is important to speak with your local GP, if you see any signs of an infection, to be able to be treated as early as possible to not cause further complications.