1. Organism
    • P. Aeruginosa
    • Gram negative rod, aerobic
    • Production of pyocyanin (blue pigment)
    • Highly resistant to antibiotics
    • Normal media
    • High level of cytochrome oxidase (positive oxidase test differentiates it from enterobacteriaceae
    • LPS and porin proteins on outermembrane
  2. Extracellular products
    • Alginate capsule: slime layer; alginate secretion, virulence factor
    • Exotoxin A: blocks EF-2; ADP-R; stops protein synthesis
    • Exoenzyme S: ADP-Rs several intracellular proteins
    • Elastase: lung tissue, IgA/G, complement
    • Phospholipase C: hemolysis, Beta-hemolysis
  3. Epidemiology
    • Environmental
    • 2-10% of healthy people
    • Rare in healthy persons
    • Major cause of morbidity in CF
    • Able to survive an replicae in water
  4. Pathogenesis
    • Significant break in first line defenses
    • Attachement to epithelial cells via pili, flagella, slim
    • Exoenzyme S directly injected into cells and has cytotoxin effect by targeting cytoskeleton
  5. CF
    • Most persistant infection with CF
    • Biofilm created in lungs
    • Multiple mutations in regulatory genes wich are activated by high osmolarity of CF secretions
    • Biofilm induces attachment, blocking of immune system and antibiotics
    • Biofilm composed of alginate
    • mats down cilia
  6. Manifestations
    • Burn infections: leading cause of morbidity and mortality
    • Infection sin compromised hosts
    • Eye infections: blindness
    • Bronchitis and pneumonia: CF
    • Eat infections: swimmers ear
    • UTIs
    • Pneumonia: rapid, destructive, alveolar necrosis, vascular invasion and bacteremia
    • bacteremia=high mortality rate
    • Chronic in CF patients
  7. Diagnosis
    • Readily grown in culture
    • Oxidase positive colonies
  8. Treatment
    • Resistant to antibiotics
    • Porins restrict access to cell
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