Infection Disease: Multidrug Resistant Pseudomonas Aeruginosa (MDRP) Infection

• Pseudomonas aeruginosa prone to resistant bacteria by antibacterial drug.
• Healthy person is hardly infected.
• For severely diseased person, combination therapy with antibacterial drug is the basic treatment.

Pseudomonas aeruginosa prone to resistant bacteria by antibacterial drug.

Pseudomonas aeruginosa is widely spread around the native environment like underwater or underground, and separated from fresh vegetable, then they are kept in the intestine of healthy person. In case when resistant power weakened person is kept this in the body, for example in the intestine, although one is performing infection management, infection by pseudomonas aeruginosa may occur from inside the body. At hospital, it is separated from plumbing area like sink or restrooms so that antiseptic substance, artificial respirator or endoscope might be infected. There is a tendency that large amount of antibacterial drug is used as it prone to resistant bacteria.Multidrug resistant Pseudomonas aeruginosa is the bacteria which shows resistance characteristics for carbapenem, quinolone, aminoglycoside antibiotic.

Healthy person is hardly infected.

Pseudomonas aeruginosa is often separated together with Staphylococcus aureus from clinical materials. It causes several infectious diseases; blood poisoning, lung inflammation, infection of the urinary tract, or biliary infection. It merely infect to healthy people so that most of the people who are infected are; person who is administrated large volume of antibacterial drug or anticancer drug, leukemia, hepatic failure, severe diabetes, AIDS, always catheter inserted person, and high-aged person especially who is keeping its bed.

Generally speaking, factors that predict multidrug-resistant bacteria are;

1. Having anamnesis used antibacterial drug in past 90 days. (especially carbapenem series, Higher cephalosporins series, quinolone series)
2. 5 days passed from hospitalization.
3. Transferred from an area or hospital having a lot of resistant bacteria.
4. Risk of lung inflammation medical treatment related; hospitalized in the past 90 days, living in the chronic Care facility, like Health and Welfare facility for the elderly, family member of the patient who has multi-drug resistant bacteria.

For severely diseased person, combination therapy with antibacterial drug is the basic treatment.

Antibacterial drug is not necessarily used for bacterial carrier since no symptom appears so that if in case antibacterial drug is administrated additional drug-resistant strain. Drainage or debridement (remove dead tissue which interfere to be cured) are also important. Skin infection may be cured by debridement only.

Antibacterial drug is necessary for the infection, but beta-lactam drugs including carbapenem-based drugs is almost ineffective so that combination therapy is the basic treatment for severe MRDP. Azactam (AZT), Aminoglycoside-based drugs : Amikacin, Gentasin, and Tobracin are commonly used in combination. There is a case where Anti-MRSA drugs Habekacin is effective. Colistin is known as it has a strong antibacterial activity.

Referenced documents

• Textbook for Infectious disease Specialist Part I Comments. By Nankoudo 2011
• Makoto Aoki; Infection disease diagnosis manual, Third edition By Igaku Shoin 2016
• Therapeutic Agent Today 2016, by Nankodo