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PubMed1986

Effects of Lactobacillus casei on Pseudomonas aeruginosa infection in normal and dexamethasone-treated mice.

A single intraperitoneal injection of Lactobacillus casei YIT 0003 into normal or dexamethasone-treated mice led to nonspecific resistance against intraperitoneal challenge with lethal doses of Pseudomonas aeruginosa PAO 3047. The enhanced resistance was retained for 14 days (P less than 0.05) after injection with living L. casei. In contrast, the statistically significant duration of the enhanced resistance in mice treated intraperitoneally with living L. acidophilus YIT 0075 was only 5 days. The in vivo killing activity of peritoneal exudate cells (PECs) against P. aeruginosa 5 and 7 days after intraperitoneal injection of living L. casei was significantly higher than in the case of PECs elicited by L. acidophilus. In the case of intravenous injection of heat-killed L. casei before intraperitoneal challenge with P. aeruginosa, there were no survivors in the late period after administration of L. casei. A high correlation existed between the patterns of in vivo killing of P. aeruginosa by PECs and survival rate of mice injected intravenously with heat-killed L. casei. The reduced in vivo killing activity of PECs from dexamethasone-treated mice against P. aeruginosa infection was also augmented by the intraperitoneal injection of heat-killed L. casei. These results indicate that L. casei possesses a resistance-enhancing capacity against P. aeruginosa infection in vivo. Differences in the duration of the enhanced resistance caused by L. casei and by L. acidophilus may be due to differences in chemical composition and/or physicochemical properties of the cell walls of the two kinds of bacteria.

Animals↗
PubMed1996

Community-acquired Pseudomonas aeruginosa infection in an infant.

A 7-month-old infant presented at a tertiary centre with a 6-day history of a skin rash, fever and diarrhoea. Clinical features included pyrexia, kwashiorkor, extensive ulcerating skin lesions suggestive of ecthyma gangrenosum, hepatomegaly, meningismus, neutropenia and iron deficiency anaemia. Blood and skin aspirate cultures yielded a positive growth of Pseudomonas aeruginosa. Apart from severe protein energy malnutrition, no other causes of immunodeficiency were found. He responded well to parenteral antibiotic therapy with gentamicin and piperacillin.

Anti-Bacterial Agents↗
PubMed1985

Comparative activities of piperacillin, ceftazidime, and amikacin, alone and in all possible combinations, against experimental Pseudomonas aeruginosa infections in neutropenic rats.

This study compared the efficacy of therapy with the double beta-lactam combination of ceftazidime plus piperacillin with that of single-agent therapy with ceftazidime, piperacillin, or amikacin alone and with that of two aminoglycoside-beta-lactam combinations against Pseudomonas aeruginosa peritonitis and bacteremia in neutropenic rats. Rats made severely granulocytopenic with cyclophosphamide became bacteremic secondary to peritonitis which was induced by intraperitoneal challenge with P. aeruginosa. Antibiotic therapy with single agents (amikacin, 20 mg/kg of body weight, intramuscularly; ceftazidime, 20 mg/kg of body weight, subcutaneously; piperacillin, 200 mg/kg of body weight, intramuscularly) or with the various combinations of agents was begun 2 h after bacterial challenge and was continued every 6 to 8 h for 62 h. Therapeutic efficacy was judged on the basis of survival 72 h after bacterial challenge, rate of mortality, incidence of bacteremia, and the emergence of resistant organisms. Based on these criteria, therapy with the double beta-lactam combination had no advantage over single-agent therapy and was in all cases clearly inferior to beta-lactam-aminoglycoside combinations.

Amikacin↗
PubMed1986

Enoxacin in lower respiratory tract infections.

In this open, non-comparative study 45 lower respiratory tract infections were treated with the new 4-quinolone, enoxacin. Special attention was paid to infections caused by Pseudomonas aeruginosa. Pseudomonas infections were treated with 600 mg bd. whereas infections caused by other bacteria were treated with 400 mg enoxacin bd. In 43 cases efficacy could be assessed. In six out of 23 cases Pseudomonas spp. were eradicated from the sputum. In 12 of the remaining 17 cases a clear reduction in bacterial numbers and a decrease of sputum volume and purulence were obtained. Clinical improvement or cure was obtained in 20 out of the 23 cases. Most of the causative microorganisms in the other infections were eradicated. In two patients Staphylococcus aureus persisted. Overgrowth with streptococci occurred in three patients. Adverse reactions were frequent and occurred in 29 out of 45 treatment periods. They were mainly related to the gastrointestinal tract and the central nervous system. In 25 out of 30 patients on concomitant treatment with theophylline an elevation of plasma theophylline concentrations occurred. Twelve of these patients developed signs and symptoms possibly related to theophylline toxicity. After treatment with enoxacin the MICs of most persisting Pseudomonas strains were two to four times higher than pre-treatment values.

Adult↗
PubMed1984

Immunoserology of Pseudomonas aeruginosa infections in man. I. Four types of interaction between host and bacterium.

Continuous survey of clinical symptoms, bacteriological findings and anti-LPS antibodies in 39 acute and 9 chronic patients at a respiratory department revealed four interaction-types between Pseudomonas aeruginosa and host: I, clinical complications with a serological response; II, the same without serological answer; III, rise of specific antibodies without clinical symptoms; and IV, no clinical or serological reaction despite the presence of P. aeruginosa. Exogenous factors like massiveness or mode of infection (e.g. instrumental) determined mainly the type of interaction in the absence of immune-antibodies. P. aeruginosa colonization longer than a few days turned generally into manifest or subclinical infection. The lack of antibody production in severe infection was likely a consequence of an immune-paralysis, elicited by a massive infection. Antibody production was lower in subclinical than in manifest infection, yet IgG-type antibodies increased not only in the latter, but always in the former, too.

Adolescent↗
PubMed2004

[Pseudomonas aeruginosa infection presenting as gonorrhea].

A 68 year old man presented with urethritis and a purulent discharge, carrying the tentative diagnosis of gonorrhea. He had already been treated with multiple antibiotics. Microbiological investigation revealed Pseudomonas aeruginosa, a relatively frequent Gram-negative bacteria in hospitals, which can cause several nosocomial diseases such as pneumonia, wound infections and urogenital infections. Therapy can be difficult because of frequent antibiotic resistance. Guided by sensitivity studies, the patient was successfully treated with gyrase inhibitors. Pseudomonas aeruginosa-induced urogenital infections in ambulatory patients are extremely rare and usually not associated with a gonorrhea-like discharge.

Aged↗
PubMed1984

[Role of azlocillin in the treatment of Pseudomonas urinary infections].

Ten cases of urinary tract infection (6 acute and 3 relapsing) treated with azlocillin are reported. Nine patients had a history of urinary tract catheterization or in-dwelling catheter and 6 had previously undergone surgery. Prior to receiving azlocillin, 6 of the patients had been unsuccessfully treated with other antibiotics. Renal function was altered in 6 cases. Azlocillin was administered intravenously in doses of 5 grams three times or twice a day for periods ranging from 8 days (in 2 cases) to 26 days. The antibiotic was given alone in all but 2 cases where it was associated with amikacin. Excellent clinical and bacteriological results were obtained in 9 of the 10 cases, with only one failure. No local, systemic or biochemical side-effect was recorded. Bacteriological results were most satisfactory. The minimum inhibitory concentrations of azlocillin were lower than those of carbenicillin in all cases. Sensitivity of azlocillin was even good in 3 and intermediate in 2 of the 5 cases where Pseudomonas was indifferent or resistant to carbenicillin. In spite of the small number of cases in this series, these results indicate that azlocillin ranks among antibiotics that are effective in urinary tract infections due to Pseudomonas.

Adolescent↗
PubMed2003

Evaluation of a new definition for chronic Pseudomonas aeruginosa infection in cystic fibrosis patients.

BACKGROUND: Patients were defined each successive month as either 'chronic' when more than 50% of the preceding 12 months were PA culture positive, 'intermittent' when < or =50% of the preceding 12 months were PA culture positive, 'free of PA', with no growth of PA for the previous 12 months, having previously been PA culture positive, or 'never infected', when PA had never been cultured. METHODS: Cross-sectional analysis of 146 children attending the Leeds Regional Cystic Fibrosis Centre was performed to assess relationship between the new definition and clinical scores and investigations. The response variable was regressed on age and sex and the residuals analysed using the Kruskal-Wallis test. RESULTS: The 'chronic' group (18% of patients) had significantly worse Shwachman-Kulczycki (SK) and Northern chest X-ray scores, and % predicted FEV(1) values than the 'free' (28%) or 'never' (20%) categories (P<0.004). The 'intermittent' group (34%) had a significantly higher SK score than the 'chronic' group (P<0.0001), and a significantly lower % predicted FEV(1) value than the 'free' or 'never' groups (P<0.0003). 'Chronic' patients were significantly associated with a positive, and 'never' patients with a negative, PA antibody result (P<0.001). CONCLUSIONS: The validity and importance of identifying these four subgroups is demonstrated. Previous definitions may over-estimate the prevalence of chronic infection.

Adolescent↗
PubMed1993

Outbreak of Pseudomonas aeruginosa infections in a surgical intensive care unit: probable transmission via hands of a health care worker.

Pseudomonas aeruginosa was isolated from nine patients (16.2 isolations/1,000 patient-days) in a surgical intensive care unit during an outbreak in November 1990; this rate of isolation was three times higher than that noted previously on this unit. Three patients were infected with the same strain, as defined by identical serotypes, pyocin types, and contour-clamped homogeneous electric field (CHEF) electrophoresis patterns of digested genomic DNA. The hands of 80 health care workers were cultured, and a strain of P. aeruginosa identical to that infecting the three patients was isolated from the hands of a nurse providing care to all three. Environmental surfaces, medical devices, and ward stock supplies were cultured; none of these cultures yielded this strain. No clusters of infection with this strain or other strains of P. aeruginosa were observed after compliance with hand-washing and universal precautions was reemphasized. Thus this outbreak was linked to the carriage of P. aeruginosa on the hands of a health care worker. It could not be determined definitively whether this carriage was the source of the cluster or a consequence of it. However, the geographic and temporal clustering of carriage with an outbreak due to a strain of an apparently identical molecular type underlines the importance of routine hand washing between contacts with different patients.

Adult↗
PubMed2006

Role of granulocyte macrophage colony-stimulating factor during gram-negative lung infection with Pseudomonas aeruginosa.

Granulocyte macrophage colony-stimulating factor (GM-CSF) stimulates survival, proliferation, differentiation, and function of myeloid cells. Recently, GM-CSF has been shown to be important for normal pulmonary homeostasis. We report that GM-CSF is induced in lung leukocytes during infection with Gram-negative bacteria. Therefore, we postulated that deficiencies in GM-CSF would increase susceptibility to Gram-negative infection in vivo. After an intratracheal inoculum with Pseudomonas aeruginosa, GM-CSF-/- mice show decreased survival compared with wild-type mice. GM-CSF-/- mice show increased lung, spleen, and blood bacterial CFU. GM-CSF-/- mice are defective in the production of cysteinyl leukotrienes, prostaglandin E2, macrophage inflammatory protein, and keratinocyte-derived chemokine in lung leukocytes postinfection. Despite these defects, inflammatory cell recruitment is not diminished at 6 or 24 h postinfection, and the functional activity of polymorphonuclear leukocytes from the lung and peritoneum against P. aeruginosa is enhanced in GM-CSF-/- mice. In contrast, alveolar macrophage (AM) phagocytosis, killing, and H2O2 production are defective in GM-CSF-/- mice. Although the absence of GM-CSF has profound effects on AMs, peritoneal macrophages seem to have normal bactericidal activities in GM-CSF-/- mice. Defects in AM function may be related to diminished levels of IFN-gamma and TNF-alpha postinfection. Thus, GM-CSF-/- mice are more susceptible to lung infection with P. aeruginosa as a result of impaired AM function.

Animals↗