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PubMed1990

Brain abscess: with special reference to infection by pseudomonas.

Eighty cases of brain abscess treated in the University Hospital, BHU, Varanasi, India have been reviewed. Chronic suppurative otitis media was the commonest cause, followed by compound injuries. The overall mortality was 15%. In seven cases the causative organism was pseudomonas, resistant to most antibiotics. Prior to the availability of CT the mortality was 23.3%; after the routine use of CT for diagnosis the mortality fell to 10%. A high mortality (57%) was observed in patients who had pseudomonas. The best results were in patients who had been managed by excision of the abscess capsule.

Adolescent↗
PubMed1995

Corneal ulcers in two institutions in Singapore: analysis of causative factors, organisms and antibiotic resistance.

The aim of this study was to determine the causative factors, organisms and antibiotic resistance in patients with bacterial keratitis in Singapore. We analysed retrospectively 103 cases of bacterial keratitis admitted to the Singapore General Hospital or the Singapore National Eye Centre during a 21-month period from March 1992 to December 1993. Contact lens wear represented the largest single predisposing factor (35 eyes, 34.0%), followed by ocular trauma (28 eyes, 27.2%) and pre-existing ocular disease (28 eyes, 27.2%). Thirteen of the twenty-eight cases of trauma-related keratitis were work-related injuries. Gram-negative organisms formed the largest group (41 cultures, 80.4%), with Pseudomonas aeruginosa being the most common organism identified (30 eyes). Pseudomonas was also responsible for 78.6% of all contact lens ulcers (11 out of 14 eyes). Resistance to gentamicin was only encountered in 1 case of Proteus mirabilis keratitis. All cases of Pseudomonas infection and 3 of the 10 Gram-positive cases were also resistant to chloramphenicol. All Gram-positive cases were sensitive to cephalosporins. Contact lens wear and ocular trauma are the major preventable risk factors for bacterial keratitis in young sighted eyes in Singapore. Gentamicin continues to be the antibiotic of choice for Gram-negative corneal infections in view of the low incidence of resistance. The routine use of chloramphenicol as the topical antibiotic of choice for corneal infection is not recommended due to the high resistance in Gram-positive and Gram-negative organisms locally.

Adult↗
PubMed1992

Life-threatening Pseudomonas aeruginosa infections in patients with human immunodeficiency virus infection.

Bacterial infections are a well-described complication of AIDS. However, relatively few reports have described infections due to Pseudomonas aeruginosa in adults who are infected with the human immunodeficiency virus (HIV). Seven cases of serious P. aeruginosa infection in HIV-infected patients occurred during 12 months in two hospitals in Houston, often in the absence of other host factors that are generally thought to predispose to this condition. One patient had no prior illness or antibody test results that were suggestive of HIV infection; for two other patients who were known to have antibody to HIV, an AIDS-defining diagnosis had never been made. Three patients had pneumonia (two with bacteremia and one with empyema), one had malignant otitis externa, and three had bacteremia that either resulted from or caused secondarily a soft-tissue focus of infection. Two patients died, and two others experienced one or more relapses after an initial course of treatment. Compromised host defense mechanisms, including loss of mucosal integrity, defects in humoral and cellular immunities, and qualitative or quantitative leukocyte abnormalities, may predispose HIV-infected patients to P. aeruginosa infections.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Contribution of the regulatory gene lasR to the pathogenesis of Pseudomonas aeruginosa infection of burned mice.

Pseudomonas aeruginosa is a gram-negative opportunistic pathogen that causes severe infections in patients with burns. The P aeruginosa regulatory gene, lasR, regulates the expression of several virulence factors. The specific lasR isogenic mutant, PAO-R1, is defective in the synthesis of the 2 elastases (LasB and LasA) and produces low levels of exotoxin A and alkaline proteases. In this study, we used a burned mouse model to examine the role of lasR in the pathogenesis of P aeruginosa infections. We have examined the following aspects of P aeruginosa infections: 1) lethality to the burned mouse, 2) the dissemination within the body of the burned mouse, and 3) the local spread within the burned skin. In comparison with its parent strain, PAO1, PAO-R1 was less lethal. In addition, the numbers of PAO-R1 microorganisms recovered from the livers and spleens of the burned mice were less than those of PAO1. Furthermore, at 8 hours postinfection, equivalent numbers of PAO1 and PAO-R1 were detected at the inoculation site of the burned skin. However, only PAO1 microorganisms were detected at other sites of the burned skin. These results suggest that the lasR gene contributes (directly and indirectly) to the dissemination of P aeruginosa within the body of burned mice and its horizontal spread within the burned skin.

Animals↗