Impact of Pseudomonas aeruginosa Infection on Patients with Chronic Inflammatory Airway Diseases

Abstract

Pseudomonas aeruginosa (P. aeruginosa) is a ubiquitous and opportunistic microorganism and is considered one of the most significant pathogens that produce chronic colonization and infection of the lower respiratory tract, especially in people with chronic inflammatory airway diseases such as asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), and bronchiectasis. From a microbiological viewpoint, the presence and persistence of P. aeruginosa over time are characterized by adaptation within the host that precludes any rapid, devastating injury to the host. Moreover, this microorganism usually develops antibiotic resistance, which is accelerated in chronic infections especially in those situations where the frequent use of antimicrobials facilitates the selection of “hypermutator P. aeruginosa strain”. This phenomenon has been observed in people with bronchiectasis, CF, and the “exacerbator” COPD phenotype. From a clinical point of view, a chronic bronchial infection of P. aeruginosa has been related to more severity and poor prognosis in people with CF, bronchiectasis, and probably in COPD, but little is known on the effect of this microorganism infection in people with asthma. The relationship between the impact and treatment of P. aeruginosa infection in people with airway diseases emerges as an important future challenge and it is the most important objective of this review.

Antimicrobial Resistance in Common Respiratory Pathogens of Chronic Bronchiectasis Patients: A Literature Review

“…Furthermore, P. aeruginosa can develop resistance also through mutations or gene acquisition via horizontal gene transfer. Persistent P. aeruginosa infection has been associated to poorer outcomes, as airway inflammation, morbidity, hospitalization risk and premature mortality, in both CF and NCFB [ 41 , 42 , 43 ].…”

“…S. aureus and S. pneumoniae (as two examples for gram-positive bacteria) are in both chronically infected patient groups common [ 37 ]. NCFB patients demonstrate a greater variety of chronic pathogens compared with CF bronchiectasis patients showing tendentially a more classical S. aureus infection pattern [ 73 , 75 ] with commonly subsequent P. aeruginosa infection [ 43 ]. In the past years, research on the characteristics of NTM infections has been steadily increasing [ 76 ].…”

Current microbiological aspects of community respiratory infection beyond COVID-19

“…Por otra parte, aunque no es uno de los factores microbiológicos exclusivamente determinantes en la elección de los selección es elevada [17,46]. Incluso se han descrito clones de alto riesgo y aislados productores de carbapenemasas y analizado la posible influencia de la hipermutación en la selección de aislados multirresistentes [17,47,48].…”

The DEAD-box RNA helicases RhlE2 is a global regulator ofPseudomonas aeruginosalifestyle and pathogenesis

“…The bacterium has a remarkable distribution across multiple ecological niches, including a wide variety of hosts (21)(22)(23). In humans, P. aeruginosa infections pose a significant life threat to immunocompromised and immunodeficient persons, intensive care patients, patients with cystic fibrosis or other forms of bronchiectasis and chronic obstructive pulmonary diseases (24)(25)(26)(27)(28). As opportunistic pathogen, P. aeruginosa possesses a remarkable virulence plasticity, being able to colonize different type of organs and modify its virulence strategy and physiology in response to the host context (29).…”