ABSTRACT
Pseudomonas aeruginosa is a common and highly lethal agent of nosocomial infection, especially among intensive
care unit patients. It is widespread in the environment and commonly recovered from
water in nature and in hospital settings.
P. aeruginosa is endowed with a formidable array of virulence factors that facilitate attachment
to host cells, tissue invasion, and systemic disease. It is intrinsically resistant
to many commonly employed antibiotics due to a complex variety of mechanisms briefly
reviewed here. Resistance to fluoroquinolones appears to be increasing particularly
rapidly.
Recent advances in the understanding of the molecular biology of this organism have
shed considerable light on its ability to form biofilms, which facilitate adherence,
especially in cystic fibrosis patients, and confer resistance to clearance by host
immune mechanisms and antimicrobial killing.
Treatment studies have demonstrated a significant risk of emergence of resistance
during therapy with a variety of agents. Several studies suggest that two drugs are
better than one for therapy of serious infections, although dual therapy does not
always prevent emergence of resistant strains. The sequencing of the genome will lead
to new understanding of pathogenesis and may identify new drug targets.
KEYWORDS
Pseudomonas aeruginosa, ICU infections - pathogenesis
