What Is Involved in Pseudomonas Testing?

Pseudomonas aeruginosa pneumonia refers to inflammatory lesions in the lungs caused by Pseudomonas aeruginosa infection. It is more common in nosocomial infections, is more severe, the infection is difficult to control, and the mortality rate is high. Pseudomonas aeruginosa is widely present in humid environments and is likely to invade patients with underlying diseases, immunocompromised or intensive care, and mechanical ventilation. The incidence has increased significantly in recent years.

Basic Information

Visiting department: Respiratory
Multiple groups: Patients with underlying disease, immunocompromised or intensive care, mechanical ventilation
Common locations: Lungs

Common causes: Caused by Pseudomonas aeruginosa infection
Common symptoms: Body temperature fluctuates greatly, cough, purulent sputum; in severe cases, dyspnea, cyanosis, wet lung sounds, empyema, or even confusion, respiratory failure, renal insufficiency, etc.

Causes of Pseudomonas aeruginosa pneumonia

Pseudomonas aeruginosa is the main pathogenic bacteria in humans in the genus Pseudomonas. It is a gram-negative bacillus. Extreme flagella are arranged in single or in pairs. The flagella has heat-resistant antigens. Sex polysaccharide layer. Although the bacteria are aerobic, they can grow under anaerobic conditions, grow well at 25 to 37 ° C, and can tolerate high concentrations of hydrochloric acid, disinfectants and general antibiotics, so they are the main pathogens of nosocomial infections. The colonies are flat ground glass-like and produce hemolysin, which is related to the formation of lung infections. 90% of Pseudomonas aeruginosa can produce extracellular proteases, leading to bleeding and necrotizing lesions. The A toxin produced by this bacterium has the greatest virulence, and can inhibit the protein synthesis of susceptible cells. There are two types of clinical, bacteremia pneumonia comes from blood source or monocyte phagocytic cells; non-bacteremia pneumonia is caused by inhalation of upper respiratory tract secretions.

Clinical manifestations of Pseudomonas aeruginosa pneumonia

Symptoms of systemic poisoning are severe, and body temperature fluctuates greatly; cough, purulent sputum, a few patients are emerald green purulent sputum; severe patients have dyspnea, cyanosis, auscultation of the lungs can be heard and wet murmur, some patients develop empyema, serious When the mind is blurred, it is easy to be complicated by respiratory failure, renal insufficiency, shock, electrolyte disturbance, and heart failure.

Pseudomonas aeruginosa pneumonia test

Laboratory inspection

The white blood cell count can be moderately high or normal. Blood biochemical examination, low potassium, sodium, chlorine, liver and kidney and other organ damage may also occur.

2. Other auxiliary inspections

X-ray has no specific manifestations. It is usually diffuse bilateral bronchial pneumonia, which may involve multiple lung lobes, and the lower lobes are common. Lesions can be small abscesses, or large infiltrations, or multiple small abscesses, or a small amount of pleural effusion.

Diagnosis of Pseudomonas aeruginosa pneumonia

Typical clinical manifestations and X-ray signs are easily diagnosed by combining sputum smear culture and pleural effusion culture.

Differential diagnosis of Pseudomonas aeruginosa pneumonia

It should be distinguished from Staphylococcus aureus pneumonia, Legionella pneumonia, typhoid and other Gram-negative pneumonia. It is necessary to identify the patient's medical history, imaging and etiology tests, and to choose effective antibiotics in a timely manner.

Complications of Pseudomonas aeruginosa pneumonia

Severe patients may have bacteremia, respiratory failure, renal insufficiency, heart failure, pleural effusion, and gastrointestinal bleeding, etc., with a higher mortality rate.

Pseudomonas aeruginosa pneumonia treatment

Due to the special cell wall structure of the bacteria, and easy to produce chromosome-inducing enzymes under the use of antibiotics, it can hydrolyze -lactam antibiotics, so it should be treated with large doses, long courses, and combined medication. The antibiotics used for Pseudomonas aeruginosa are mainly -lactam antibiotics, such as semi-synthetic penicillin and cephalosporins. The commonly used semi-synthetic penicillins are carbenicillin; furicillin, piperacillin, intravenous Drip. Due to the increased resistance of the bacteria to carbenicillin, and the activity of piperacillin is significantly higher than that of carbenicillin, therefore, piperacillin is often used in clinic instead of carbenicillin. Ticarcillin-clavulanate potassium, piperacillin / triazobactam sodium have also been used clinically. Generally, any aminoglycoside drugs can be added, such as gentamicin, amikacin (amikacin), etimicin, etc. to enhance the efficacy; quinolones such as ciprofloxacin, moxifloxacin It is also used routinely in the clinic; high-efficiency third-generation cephalosporins can also be used, but the effect varies widely, and ceftazidime has the best effect. Enzyme inhibitors such as cefoperazone and sulbactam, fourth-generation cephalosporins, cefepime, and cefpirome are mostly used for nosocomial infections caused by multidrug-resistant bacteria. Ultra-wide-spectrum antibacterial drugs imipenem-cilastine and meropenem can also be added to 0.9% physiological saline, and divided intravenously.

Prognosis of Pseudomonas aeruginosa pneumonia

The prognosis of this disease is poor, and the mortality rate is high. At present, most reports in the literature range from 50% to 81%.

Prevention of Pseudomonas aeruginosa pneumonia

1. Strictly implement various operations and rules and regulations, cut off the transmission of cross infection, and especially strengthen hand hygiene management.

2. Strengthen the oropharyngeal care of patients with coma to prevent respiratory infection of Pseudomonas aeruginosa.

3. Strict disinfection of medical equipment, including artificial respirators, nebulizers, tracheal intubation, etc.

4. Reasonable use of broad-spectrum antibiotics, and strictly grasp the indications for the use of corticosteroids.