Pseudomonas aeruginosa is a bacterium found naturally in soil and water. It grows mainly in moist environments, including bathrooms, swimming pools, and hot tubs.
Infection with this bacterium is more likely to occur in people with weakened immune systems. This includes older adults, newborns, and people with uncontrolled diabetes, cancer, or kidney or liver problems.
Pseudomonas aeruginosa can cause pneumonia, urinary tract infections, bacterial cellulitis, erysipelas, outer ear infections, bacterial endocarditis, and septicemia. Most cases are associated with healthcare-associated infections.
Symptoms of P. aeruginosa infection
The main symptoms of a Pseudomonas aeruginosa infection include:
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Fever or chills;
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Excessive fatigue;
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A cough with yellow or bloody mucus, chest pain, or shortness of breath;
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Eye redness, pain, or swelling, or sudden vision loss;
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Diarrhea, nausea, or vomiting;
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Muscle or joint pain.
Other symptoms may include low blood pressure, a weak heartbeat, drowsiness, ear pain or pus draining from the ear, hearing loss, or pus-filled blisters on the skin.
Symptoms of a Pseudomonas aeruginosa infection vary depending on the type of infection and the affected organ. The infection may affect the lungs, heart, ears, eyes, brain and meninges, gastrointestinal tract, bones, or skin.
A urinary tract infection caused by P. aeruginosa may also cause pain or burning during urination, abdominal pain, or blood in the urine.
How the diagnosis is confirmed
A Pseudomonas aeruginosa infection is diagnosed by a primary care physician or infectious disease specialist. The doctor will evaluate the symptoms, perform a physical examination, and review the person’s medical history, including any previous surgeries, medical procedures, or hospitalizations.
To confirm the diagnosis, the doctor may order a complete blood count and microbiological testing. Samples may be collected from urine, sputum, or secretions from the skin, eyes, or ears to identify the bacterium.
In some cases, a lumbar puncture may be performed to collect cerebrospinal fluid for testing.
Other tests may also be ordered, such as a chest X-ray, MRI, CT scan, echocardiogram, or kidney ultrasound.
Diseases caused by Pseudomonas aeruginosa
The main diseases caused by Pseudomonas aeruginosa include:
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Pneumonia;
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Urinary tract infections;
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Infections of surgical wounds or skin affected by severe burns;
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Folliculitis, bacterial cellulitis, erysipelas, or ecthyma gangrenosum;
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Meningitis or a brain abscess;
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Enteritis or enterocolitis.
Pseudomonas aeruginosa can also cause bacterial endocarditis, osteomyelitis, outer or middle ear infections, keratitis, or bacterial keratoconjunctivitis.
If it enters the bloodstream, P. aeruginosa can cause bacteremia and lead to a widespread infection known as sepsis. This condition can be life-threatening.
How transmission occurs
Pseudomonas aeruginosa can be transmitted through contact with contaminated soil or water. Possible sources include swimming pools that have not been properly treated with chlorine, hot tubs, sinks, bathrooms, kitchens, and humidifiers.
Pseudomonas aeruginosa is one of the bacteria most commonly associated with healthcare-associated infections. This is because it can survive on medical equipment or devices that have not been properly sterilized, such as urinary catheters and ventilators.
The bacterium may also be found in expired antiseptic solutions or improperly manufactured household products, such as detergents and laundry products. It can also spread when healthcare professionals do not follow appropriate hygiene practices.
Is Pseudomonas aeruginosa contagious?
Pseudomonas aeruginosa is contagious and can spread from one person to another. Transmission may occur through contact with hands or skin contaminated with the bacterium or through contact with contaminated surfaces.
Who is most at risk?
Factors that can increase the risk of a Pseudomonas aeruginosa infection include:
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HIV infection or AIDS;
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Cystic fibrosis;
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Kidney or liver disease;
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Cancer, chemotherapy, or the use of immunosuppressive medications;
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Poorly controlled diabetes;
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Organ transplants or severe burns;
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Prolonged hospitalization or surgery.
Newborns, pregnant women, and older adults also have a higher risk of Pseudomonas aeruginosa infection because their immune systems may be more vulnerable.
People who have urinary or intravenous catheters or who are receiving mechanical ventilation also have an increased risk of infection.
Is Pseudomonas aeruginosa serious?
A Pseudomonas aeruginosa infection can be serious, especially in people with weakened immune systems. In healthy people, P. aeruginosa rarely causes infection, and infections that do occur tend to be more superficial and less severe.
How treatment is performed
Treatment for a Pseudomonas aeruginosa infection should be supervised by a primary care physician or infectious disease specialist. Antibiotics may be administered as ear drops, eye drops, creams, ointments, tablets, or intravenous injections, depending on the type and location of the infection.
Antibiotic classes that may be prescribed include polymyxins, aminoglycosides, fluoroquinolones, penicillins, cephalosporins, and carbapenems.
If the Pseudomonas aeruginosa strain is resistant to the initial antibiotic, the doctor may change the medication or prescribe a combination of antibiotics.
Other treatments may include removing catheters or other medical devices. Surgery may be necessary to treat pressure ulcers, drain abscesses, repair an intestinal perforation or obstruction, or remove dead tissue through debridement.
In the most severe cases, amputation of the affected limb may be necessary.