Pseudomonas aeruginosa in Bronchiectasis

Abstract

Pseudomonas aeruginosa (PA) in patients with bronchiectasis (BE) is associated with a poor outcome and quality of life, and its presence is considered a marker of disease severity. This opportunistic pathogen is known for its ability to produce biofilms on biotic or abiotic surfaces and to survive environmental stress exerted by antimicrobials, inflammation, and nutrient or oxygen depletion. The presence of PA biofilms has been linked to chronic respiratory infection in cystic fibrosis but not in BE. There is considerable inconsistency in the reported infection/eradication rates of PA and chronic PA. In addition, inadequate antimicrobial treatment may potentiate the progression from intermittent to chronic infection and also the emergence of antibiotic resistance. A better comprehension of the pathophysiology of PA infections and its implications for BE is urgently needed. This can drive improvements in diagnostic accuracy, can move us toward a new consensus definition of chronic infection, can better define the follow-up of patients at risk of PA, and can achieve more successful eradication rates. In addition, the new technological advances regarding molecular diagnostics, -omics, and biomarkers require us to reconsider our traditional concepts.

The value of biofilm testing to guide antimicrobial stewardship in chronic respiratory diseases

“…PA isolates in respiratory specimens not accomplishing the chronic infection definition ( Fernández-Barat et al., 2021 ).…”

“…It is also associated with a higher number of exacerbations and hospitalizations, and higher symptomatology perceived by the patient ( Finch et al., 2015 ). Given the relationship between PA and poor clinical outcomes in patients with BE, its early detection and appropriate management are essential ( Fernández-Barat et al., 2021 ).…”

Real-Life Experience of Continuously Infused Ceftolozane/Tazobactam in Patients with Bronchiectasis and Multidrug-Resistant Pseudomonas aeruginosa Infection in the Outpatient Setting

“…Non-cystic fibrosis bronchiectasis is a chronic progressive respiratory disease characterized by irreversible bronchial airway dilatation and epithelial lining damage due to recurrent bacterial infections and continuous inflammation [15]. Clinically, the syndrome is characterized by sputum production, cough, dyspnea, and intermittent exacerbations that result in progressively decreasing lung function [16]. Exacerbations are associated with worse quality of life and increased socioeconomic costs due to frequent hospitalizations and subsequent mortality [17].…”

Ascorbic acid modulates the structure of the Pseudomonas aeruginosa virulence factor pyocyanin and ascorbic acid-furanone-30 combination facilitate biofilm disruption

“…P. aeruginosa is a major pathogen in patients who are immunocompromised including in the early and late stage of HIV infected patients including AIDS patients (Meynard et al, 1999). It is also a major pathogen in cystic fibrosis, bronchitis, burns and surgery-associated wounds patients (Tredget et al, 2004;Ranjan et al, 2010;Fernández-Barat et al, 2021).…”