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Pseudomonas aeruginosa

Pseudomonas aeruginosa is a Gram-negative, aerobic, rod-shaped bacterium that belongs to the genus Pseudomonas. Pseudomonas aeruginosa is a strong biofilm former.

Pseudomonas aeruginosa causes numerous different nosocomial infections. Examples are:

  • Wound infections (including burn and surgery wounds)

  • Pneumonia (especially during ventilation)

  • Urinary tract infections (particularly with prolonged used of urinary catheters)

  • Skin infections

  • Pyelonephritis (inflammation of the kidneys and renal pelvis)

  • Osteomyelitis (chronic inflammation of the bone and bone marrow)

  • Otitis externa (swimmer’s ear)

  • Keratitis/keratoconjunctivitis (inflammation of the cornea/inflammation of the cornea and conjunctiva)

  • Endocarditis (inflammation of the heart’s inner lining)

  • Meningitis (inflammation of the meninges)

  • Sepsis

Immunocompromised patients are at particularly high risk of infection. Pseudomonas aeruginosa is mainly found in the environment, in moist habitats. The pathogen can also be found in the moist environments of healthcare facilities (sinks, water pipes), which is why it is also referred to as "waterborne".

Relevance of pathogen in transmission in endoscopy

  • Gastroenterology: Very high

  • Pulmonology: Very high

  • Ear, nose, and throat: High

  • Urology: High

Relevance for endoscope surveillance

  • High concern organism

Transmission route

Infection is usually caused by contact with Pseudomonas aeruginosa in the environment. In healthcare facilities, the pathogen can be transmitted from patient to patient, e.g., via the hands of nursing staff.

Poor water quality can also cause the spread and transmission of this pathogen in healthcare facilities. The breakdown of Pseudomonas aeruginosa biofilms in water pipes, in particular, can contaminate water and cause the pathogen to spread. Using such contaminated water for final rinsing of a cleaned and disinfected endoscope may cause a recontamination of the endoscope.

Resistance to antibiotics

Pseudomonas aeruginosa shows resistance to numerous antibiotics, including most penicillins, 3rd generation cephalosporines, and carbapenems.

Further readings

  1. Duodenoscope Surveillance Sampling & Culturing, Reducing the Risks of Infection, Department of Health and Human Services Collaboration, 2018, https://www.fda.gov/media/111081/download (accessed on 04.22.2021).

  2. Gries O, Ly T: Infektologie – Kompendium humanpathogener Infektionskrankheiten und Erreger, Springer-Verlag Berlin Heidelberg, 2019.

  3. Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen, Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI), Bundesgesundheitsbl 2012 ∙ 55: 1311-1354.

  4. Pseudomonas aeruginosa in Healthcare Settings, Centers for Disease Control and Prevention, https://www.cdc.gov/hai/organisms/pseudomonas.html (accessed on 04.21.2021).

  5. Pseudomonas aeruginosa, Robert Koch-Institut, https://www.rki.de/DE/Content/Infekt/Antibiotikaresistenz/nosokomiale_Erreger/Pseudomonas.html (accessed on 04.21.2021).