OBJECTIVETo study the clinical characteristics of Pseudomonas aeruginosa (PA)-positive children in the pediatric intensive care unit, and to provide a basis for early diagnosis and reasonable treatment of PA infection.

METHODSThe clinical data of 62 children infected with PA in the pediatric intensive care unit were retrospectively reviewed,including age, affected organs, fever duration, hospital stay duration, mechanical ventilation duration, prognosis, underlying diseases, mortality, culture results and drug sensitivity test results.

RESULTSOf the 62 PA-positive children, 25 (40%) were aged under 6 months and 47 (76%) under 2 years, with a median age of 28.8 months. Twenty-seven showed one positive result for sputum culture or endotracheal tube aspirates culture, 3 showed one positive result for blood culture, and 32 showed more than two positive results for blood, sputum or endotracheal tube aspirates cultures. On average, 2.8 organs were affected in each patient, with the respiratory system involved most frequently (58 patients, 94%). The mean fever duration was 7.3 days and the mean hospital stay duration was 34.2 days. In the 62 patients, 35 (57%) were cured and 17 (27%) died. Mechanical ventilation was administered to 51 patients (82%) for a mean duration of 13.4 days. Fifty-one patients (82%) had underlying diseases. The 17 (27%) children who died had a mean age of 17.4 months and a mean CRP level of 52.6 mg/L; 14 of them had increased or normal white blood cell count, and 3 had a decreased white blood cell count.The antibiotic sensitivity of PA was 72.6% for cefoperazone/sulbactam, 70.8% for meropenem, 49.1% for imipenem, 65.1% for ceftazidime, and 44.3% for piperacillin/tazobactam. There was complete resistance to cephazolin, cefuroxime and cefotaxime.

CONCLUSIONSThe children under 2 years are prone to PA infection. Respiratory system involvements are common. Most of children infected with PA suffer from underlying diseases.The sensitivity of PA to common antibiotics is not high.

Child ; Child, Preschool ; Drug Resistance, Bacterial ; Female ; Humans ; Infant ; Intensive Care Units, Pediatric ; Male ; Microbial Sensitivity Tests ; Pseudomonas Infections ; blood ; drug therapy ; Pseudomonas aeruginosa ; drug effects ; Retrospective Studies

Scleral necrosis and infection are serious late complications of pterygium treatment and are difficult to manage. We describe a 70-year-old Chinese male who presented with scleral necrosis and Pseudomonas aeruginosa infection 15 years after the excision of a pterygium. The infection was treated early and aggressively with intensive topical and intravenous antibiotics and the thin necrotic sclera was reinforced with a donor scleral patch graft when the scleral infection was clinically controlled. The integrity of the globe was maintained by a thin layer of sclera anterior to the graft after the graft gradually shrunk in size and retracted posteriorly. The eye was saved from possible scleral perforation and endophthalmitis. This case is reported to highlight the importance of early aggressive treatment of infection and the value of prophylactic repair of scleral necrosis in the management of these late complications of pterygium treatment.
Administration, Topical ; Aged ; Anti-Bacterial Agents ; Drug Therapy, Combination ; administration & dosage ; therapeutic use ; Humans ; Injections, Intravenous ; Male ; Necrosis ; Pseudomonas Infections ; drug therapy ; Pseudomonas aeruginosa ; Pterygium ; surgery ; Sclera ; pathology ; transplantation ; Scleral Diseases ; drug therapy ; microbiology ; Surgical Wound Infection ; drug therapy ; etiology

Pseudomonas aeruginosa is an important pathogenic bacterium of nosocomial infections. The microbe easily produce biofilm which brings us much difficulties in clinical treatment. The formation processes of biofilm, including the stages of early bacteria planting, mushroom-like structure forming and extracellular matrix producing, are regulated by a series of molecules and genes. And quorum sensing system of the microbe is responsible for regulation of the whole process of biofilm formation. According to the process of biofilm formation and the mimitat associated regulation mechanism, several anti-biofilm therapeutic strategies have been applied in clinical medicine, and some novel drugs and methods are developed.
Biofilms ; growth & development ; Gene Expression Regulation, Bacterial ; Polysaccharides, Bacterial ; metabolism ; Pseudomonas Infections ; drug therapy ; microbiology ; Pseudomonas aeruginosa ; genetics ; physiology ; Quorum Sensing ; genetics ; physiology

OBJECTIVETo study the characteristics of community-acquired urinary tract infections (CAUTIs) in children, analyze the risk factors and the susceptibility of antibiotics, thus to provide references to the diagnosis and medication of Pseudomonas aeruginosa (PA)-CAUTIs. Mothod Totally 22 cases of PA-CAUTIs were selected in one hospital from Jan, 2006 to Jan, 2012, their clinical information, laboratory results and radiological images were collected, and were compared with the CAUTIs cased by E. coli of those randomly selected over the same period.

RESULTIn those 22 cases with PA-CAUTIs, the mean value of protein level was (32.25 ± 13.81) mg/ml, 19 of them were hospitalized, 6 had urinary operation history, 7 of them had long-term usage of glucocorticoids or immunosuppressive agents, and 20 had underlying diseases. A total of 22 children with 26 PA-CAUTIs episodes were compared to E. coli-CAUTIs. Compared with E. coli-CAUTIs patients, children with PA-CAUTIs more often presented with a lower albumin (P = 0.017), a history of urinary operation(P = 0.03), more cases had a history of urinary operation (P = 0.03), a long-term usage of glucocorticoids or immunosuppressive medication (P = 0.044). Through multivariate logistic regression of variables that were significant in univariate analysis (with hospitalizations, long-term usage of glucocorticoids or immunosuppressive, albumin, underlying disease and urinary operation histories), and it turned out that underlying diseases (odds ratio 8.500, 95% CI 1.513 - 47.761, P = 0.037) and with urinary operation histories (odds ratio 6.196, 95% CI 1.120 - 34.273, P = 0.037) were proved as the independent risk factors for PA-CAUTIs. Those PA bacterial strains had a 36.36% resistance rate to piperacillin, aztreonam and gentamicin, a 31.82% resistance rate to cefepime and ceftazidime, while the resistance rate (4.55%) to carbapenem antibiotics was relatively low, only to bacillosporin all the strains were sensitive.

CONCLUSIONUnderlying diseases and the urinary operation histories are the independent risk factors of the occurrence of PA-CAUTIs, carbapenem antibiotics and bacillosporin can be considered as the drugs of choice for its treatment.

Anti-Bacterial Agents ; therapeutic use ; Case-Control Studies ; Child ; Child, Preschool ; Community-Acquired Infections ; drug therapy ; epidemiology ; pathology ; Drug Resistance, Bacterial ; Escherichia coli ; drug effects ; Escherichia coli Infections ; drug therapy ; epidemiology ; pathology ; Female ; Humans ; Male ; Polymyxins ; therapeutic use ; Pseudomonas Infections ; drug therapy ; epidemiology ; pathology ; Pseudomonas aeruginosa ; drug effects ; Risk Factors ; Urinary Tract Infections ; drug therapy ; epidemiology ; pathology

OBJECTIVETo study changes in the drug-resistance of Pseudomonas aeruginosa (PA) and the use of antibiotics in burn wards so as to optimize the use of antibiotic in the future.

METHODSBacteria were isolated from specimens of blood, venous catheter, stool, sputum, urine, wound tissue from 5717 patients hospitalized in our burn wards within the duration of January 2005 to December 2009. The number of specimens examined and positive rates of bacteria were calculated. Changes in constituent ratio of cocci and bacilli, spectrum of bacteria, the drug-resistance rate of PA, and the usage of antibiotics were analyzed. The number of specimens examined, constituent ratio of cocci and bacilli, drug-resistance rate were processed with chi-square test. Bivariate correlation analysis was performed between the usage of antibiotics and the drug-resistance rate.

RESULTS(1) The number of specimens examined showed no statistical difference during the five years (with rates from 73.2% to 76.1%, χ(2) = 5.583, P > 0.05), while constituent ratio of cocci and bacilli showed statistical difference (with ratios from 105:134 to 169:126, χ(2) = 14.806, P < 0.01). The positive rates of bacteria were increasing in the five years. (2) One thousand six hundred and seventy-five strains were identified during the five years from different kinds of specimens, with 29 from blood, 39 from venous catheter, 3 from stool, 157 from sputum, 13 from urine, and 1434 from wound tissue. Among them, Staphylococcus aureus accounted for 28% to 42%, PA accounted for 10% to 25%, Acinetobacter baumannii accounted for 10% to 19%, and they were the predominant strains. (3) The difference among drug-resistance rates of PA to each kind of 12 antibiotics during the five years were statistically significant (with χ(2) values from 47.911 to 308.095, P values all below 0.01). The drug-resistance rates of PA to some antibiotics showed downward trend in the former four years, including amikacin, ceftazidime, and imipenem/cilastatin, but it rebounded in the fifth year. (4) There was descending trend in usage of cefoperazone/sulbactam and levofloxacin, but vancomycin was always used widely. (5) Drug-resistance rates of PA to 7 antibiotics, including amikacin, imipenem/cilastatin, and ciprofloxacin, etc., were positively correlated with usage of various antibiotics (with r values from 0.879 to 0.978, P < 0.05 or P < 0.01).

CONCLUSIONSIn our burn wards, drug-resistant PA was prevalent. Disinfection and isolation measures, appropriate use of antibiotics, etc. can reduce PA infection.

Anti-Bacterial Agents ; therapeutic use ; Burn Units ; Burns ; drug therapy ; microbiology ; Drug Resistance, Bacterial ; drug effects ; Female ; Humans ; Male ; Pseudomonas Infections ; drug therapy ; microbiology ; Pseudomonas aeruginosa ; drug effects ; isolation & purification

OBJECTIVE: To observe the clinical characteristics and impact on mortality of carbapenem-resistant Pseudomonas aeruginosa (CRPA) colonized or infected patients with hematological disorders in order to provide evidence for the prevention and treatment of CRPA. METHODS: The patients who were colonized or infected with CRPA in the Department of Hematology of The First Affiliated Hospital of Zhejiang Chinese Medical University from January 2020 to March 2021 were selected as the research subjects, the clinical data such as hospitalization time, primary disease treatment regimen, granulocyte count, previous infection and antibiotic regimen of these patients were analyzed, meanwhile, antibiotic regimen and efficacy during CRPA infection, 30-day and long-term survival were also analyzed. RESULTS: A total of 59 patients were included in this study, and divided into CRPA infection group (43 cases) and CRPA colonization group (16 cases). Univariate logistic regression analysis showed that ECOG score (P =0.003), agranulocytosis (P <0.001), and exposure to upper than 3^rd generations of cephalosporins and tigecycline within 30 days (P =0.035, P =0.017) were the high-risk factors for CRPA infection. Multivariate logistic regression analysis showed that ECOG score of 3/4 ( OR=10.815, 95%CI: 1.260-92.820, P =0.030) and agranulocytosis ( OR=13.82, 95%CI: 2.243-85.176, P =0.005) were independent risk factors for CRPA infection. There was a statistically significant difference in cumulative survival rate between CRPA colonization group and CRPA infection group ( χ²=14.134, P < 0.001). Kaplan-Meier survival analysis showed that the influencing factors of 30-day survival in patients with CRPA infection were agranulocytosis (P =0.022), soft tissue infection (P =0.03), and time of hospitalization before CRPA infection (P =0.041). Cox regression analysis showed that agranulocytosis was an independent risk factor affecting 30-day survival of patients with CRPA infection (HR=3.229, 95%CI :1.093-3.548, P =0.034). CONCLUSIONS Patients with hematological disorders have high mortality and poor prognosis after CRPA infection. Bloodstream infection and soft tissue infection are the main causes of death. Patients with high suspicion of CRPA infection and high-risk should be treated as soon as possible.
Humans ; Carbapenems/therapeutic use* ; Pseudomonas aeruginosa ; Soft Tissue Infections/drug therapy* ; Anti-Bacterial Agents/therapeutic use* ; Hematologic Diseases ; Survival Analysis

OBJECTIVETo study the therapeutical effects of the Chinese medicinal herb, Sophora flavescens (SFA) on a rat model of chronic Pseudomonas aeruginosa (PA) biofilm pneumonia.

METHODRats were challenged intratracheally with alginate embedded PA strain PAO579 at the concentration of 1 x 10(9) colony-forming units per milliliter (CFU x mL(-1)). After challeng on the second day, three different doses SFA or sterile normal saline (NS) were administered by gastric intubation once a day for two weeks. Two weeks post intratracheal challenge with P. aeruginosa, parameters were evaluated.

RESULTTwo weeks after challenge, a remarkable serum antibody response and significant infiltration of numerous polymorphonuclear leukocytes (PMN) with lower IFN-gamma production in the lungs were found in the model group. However, milder macroscopic and lower incidence of lung abscesses were found in all the three groups received different doses of SFA treatment compared to the model group (P < 0.001). Meanwhile, the microscopic lung pathology in all SFA-treated groups were characterized by chronic inflammation dominated by mononuclear leukocytes (MN). The rat number with acute inflammation in group II, III was significantly lower than that in the model group (P < 0.05). Furthermore, the serum level of anti-PA IgG was down-regulated in group II and III (P < 0.05 or P < 0.001), and serum IgG level was negatively correlated with the SFA doses (r = -0.95, P < 0.01). In all the SFA-treated groups higher IFN-gamma production in the lung was found compared to the model group (P < 0.001), and the lung IFN-gamma level was positively correlated with the SFA doses (r = 0.9, P < 0.02). These findings indicate that SFA has an effect on inducing Thl type of immune response. The anti-PA activity test of SFA was weakly positive whereas NS was negative.

CONCLUSIONSFA treatment significantly reduced pathology, which might be associated with a shift of local immune responding type from a Th2 like to Thl like that might provide a better protection to the rats with chronic P. aeruginosa lung infection. And these results also showed that the SFA dose of 12 g x kg(-1) was the best dosage in this present study.

Animals ; Biofilms ; drug effects ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; therapeutic use ; Female ; Male ; Pneumonia ; drug therapy ; microbiology ; pathology ; Pseudomonas Infections ; drug therapy ; microbiology ; pathology ; Pseudomonas aeruginosa ; pathogenicity ; Random Allocation ; Rats ; Rats, Wistar ; Sophora ; chemistry

OBJECTIVETo investigate the antibacterial effect of a particular antimicrobial peptide Cecropin B(CB) on Pseudomonas aeruginosa infection of wound in mice.

METHODSThirty ICR mice were enrolled in the study, and the Pseudomonas aeruginosa infection model was reproduced by excision of the full layer of dorsal skin with an area of 1 cm x 1 cm. Then they were randomly divided into C ( control, n = 10, with wet compress of isotonic saline at 3 postinjury hour( PIH) ) , M (with hydropathic compress of 100 g/L mafenide at 3 PIH), A (with wet compress of 1 000 mg/L Cecropin B at 3 PIH) groups. The changes in body temperature and hemogram in each group were determined before and 4 days after injury. Quantitative examination were used to detect the quantity of bacteria in muscular tissue of the wounds, and the survival of the mice were observed on 4 post-injury day( PID).

RESULTSThe wounds were moist with more exudation in C group,while that in other groups were dry without obvious exudation. The body temperature of the majority of the mice in each group were elevated, but the number of leucocytes in each group was lowered after operation. The quantity of bacteria in muscle in A group[ (42 +/- 50) CFU/g] was obviously lower than that in M group [(886+/-804) CFU/g, P <0.05] , and it was all obviously lower than that in C group[ (41 +/-28) x 10(5) CFU/g, P <0.01]. The number of surviving mice after 4 PID in C group was evidently smaller than that in A and M groups( P <0. 05).

CONCLUSIONThe cecropin B possesses obvious anti-bacterial effect on the Pseudomonas Aeruginosa infected wounds of ICR mice, and it can reduce the mortality.

Animals ; Antimicrobial Cationic Peptides ; therapeutic use ; Disease Models, Animal ; Insect Proteins ; therapeutic use ; Male ; Mice ; Mice, Inbred ICR ; Pseudomonas Infections ; drug therapy ; Wound Infection ; drug therapy ; microbiology

Ecthyma gangrenosum is a characteristic skin lesion of systemic infection due to Pseudomonas aeruginosa. It has a high incidence in patients with chronic disease and impaired defense mechanisms. Early diagnosis and appropriate systemic antibiotic therapy is crucial since its mortality rate is very high. We report a case of ecthyma gangrenosum in aplastic anemia.
Adult ; Anemia, Aplastic/*complications/pathology ; Case Report ; Female ; Human ; Opportunistic Infections/microbiology/pathology ; Pseudomonas Infections/*complications/microbiology/pathology ; Skin Diseases, Bacterial/drug therapy/*etiology/pathology

Anthracosis ; complications ; microbiology ; Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Bacterial ; Humans ; Imipenem ; pharmacology ; Microbial Sensitivity Tests ; Pseudomonas Infections ; complications ; drug therapy ; microbiology ; Pseudomonas aeruginosa ; drug effects ; Pulmonary Heart Disease ; complications ; microbiology