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PseudomonaceaeBIOL533Lecture13MedicalMicrobiologyBIOL5331PseudomonaceaeBIOL533MedicalGeneralAspectsEcology FoundthroughouttheenvironmentVerysimplenutritionalrequirementsNotusuallyinnormalfloraunlesshospitalizedorimmunocompromisedBIOL5332GeneralAspectsEcology BIOL53GeneralAspectsVirulencePossessnumberofstructuralfactorsandtoxinsResistanttomostcommonantibioticsSurprisingthattheydonotconstituteproblemingeneralpopulationBIOL5333GeneralAspectsVirulenceBIOLMicrobialPhysiology

andStructureMorphologyStraightorslightlycurvedGram—bacterialPolarflagella;motileSomestrainsappearmucoidduetopolysaccharidecapsuleSomeproducediffusiblepigmentsPyocyanin(blue),fluorescin(yellow),pyorubin(red-brown)BIOL5334MicrobialPhysiology

andStruMicrobialPhysiology

andStructurePhysiologyCarbohydratefermentationUseonlyfewCHOusingoxidativepathwaysGlucose,ribose,gluconateOxygenisterminalelectronacceptorPresenceofcytochromeoxidaseDistinguishesfromEnterobacteriaceaeAnarobicgrowthcanoccurbyusingmitrateasterminalacceptorBIOL5335MicrobialPhysiology

andStruVirulenceFactorsAdhesins:piliandnonpilusadhesinsProductionofneuraminidaseenhancesadherenceAlginate(mucoidlayer):ProtectsagainstphagocytosisandfacilitatesadherencetohostcellsBIOL5336VirulenceFactorsAdhesins:pilVirulenceFactorsElastase:causedamagetobloodvesselwalls,resultinginhemorrhagiclesions(ecthymagangrenosum)AssociatedwithdisseminatedPseudomonasinfectionsPyocyanin:mediatestissuedamagethroughtoxicoxygenradicalsBIOL5337VirulenceFactorsElastase:cauToxinsExotoxinA:mechaismlikediphtheriatoxin,butmuchmilderTwotoxinsarestructurallyandimmunologicallydifferentExoenzymeS:alsoADP-ribosyltrnasferase,butheatstabileFoundin33.3%clinicalisolatesBIOL5338ToxinsExotoxinA:mechaismlikClinicalSyndromesofPseudomonasaeruginosaBacteremiaCommoninpatientswithneutropenia,diabetesmellitus,extensiveburns,ahematologicmalignanciesOriginatefrominfectionsoflowerrespiratorytract,urinarytract,skin,andsofttissueAssociatedsymptoms:minorityofpatientshaveecthymagangrenosumBIOL5339ClinicalSyndromesofPseudomoClinicalSyndromesofPseudomonasaeruginosaEndocarditisObservedprimarilyindrugabusersSourceiscontaminateddrugequipmentAnatomyofheartaffectedTricuspidvalve:chronicandmorefavorableprognosisAorticormitralvalve:acuteandfrequentlyfatalBIOL53310ClinicalSyndromesofPseudomoClinicalSyndromesofPseudomonasaeruginosaPulmonaryinfectionsRangefromcolonizationtoseverenecrotizingbronchopneumoniaColonizationseeninpatientswithcysticfibrosis,otherchroniclungdiseases,andneutropeniaBIOL53311ClinicalSyndromesofPseudomoClinicalSyndromesofPseudomonasaeruginosaEarinfectionsSwimmer’sear:canbemanagedwithtopicalantibioticsanddryingagentsMalignantexternalotitis:morevirulent;caninvadeunderlyingtissuesandcausedeathSurgicalandantimicrobialinterventionrequiredBIOL53312ClinicalSyndromesofPseudomoClinicalSyndromesofPseudomonasaeruginosaBurninfections—severeburnsColonizationofwoundfollowedbylocalvasculardamageandtissuenecrosisLeadingtobacteremiaPredispositionMoisttissuesurfaceandabsenceofneutrophilsTopicalcreamsandwoundmanagementhashadonlylimitedsuccessBIOL53313ClinicalSyndromesofPseudomoClinicalSyndromesofPseudomonasaeruginosaOtherinfectionsLocalizedingastrointestinalandurinarytractsEyeandcentralnervoussystemMusculoskeletalsystemBIOL53314ClinicalSyndromesofPseudomoClinicalSyndromesofPseudomonasaeruginosaPrerequisitesforinfectionPresenceoforganisminmoistreservoirCircumventionorabsenceofhostdefensesCutaneoustraumaEliminationofnormalfloraNeutropeniaBIOL53315ClinicalSyndromesofPseudomoLaboratoryDiagnosisGrowonmostcommonlaboratorymediaIdentificationMorphologyColonysizeandhemolysis:flatcolonywithspreadingborderPigmentation:greenOdor:sweet,grape-likeOxidase+BIOL53316LaboratoryDiagnosisGrowonmoTreatmentResistanttolargenumberofantibioticsProblems:Productionof-lactamaseAminoglycosidesineffectiveinacidicenvironmentofabscessSuccessfultreatmentCombinationof-lactumantibioticandamioglycosideBIOL53317TreatmentResistanttolargenuPreven

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