Antimicrobial resistance mechanisms in Pseudomonas aeruginosa.

摘要

Pseudomonas aeruginosa is one of the leading causes of healthcare-associated infections (HAI). In the more severe infections such as bacteremia and pneumonia, mortality rates are high, and the infection is often difficult to treat because there are limited drugs with anti-pseudomonal activity. Infections caused by P. aeruginosa may be treated with antimicrobial agents from three major groups based on mechanism of action: aminoglycosides (interference with protein synthesis) such as tobramycin or amikacin; beta-lactams (inhibition of cell wall synthesis) such as piperacillin, ticarcillin, 3rd and 4th generation cephalosporins (ceftazidime and cefepime), and carbapenems like imipenem or meropenem; or fluoroquinolones (cipro-floxacin) (interference with nucleic acid replication). In 2005, the National Healthcare Safety Network (NHSN) began collecting, summarizing and reporting data on antimicrobial-resistant pathogens that cause HAI. As described in their 2008 report, HAI pose an "ongoing and increasing challenge to hospitals, both in the clinical treatment of patients and in the prevention of the cross-transmission of these problematic pathogens".