Intrinsic resistance mechanisms in P.aeruginosa and alternative treatment options

Author: Sophio Gholadze
Keywords: Pseudomonas aeruginosa, antibiotic resistance, resistance mechanisms, alternative treatment options
Annotation:

Pseudomonas aeruginosa is a common cause of nosocomial infections; it is one of the most frequently isolated pathogen in the patients, hospitalized for longer than a week. P.aeruginosa is not only associated with gastrointestinal, urinary tract or systemic infections, but also it is a leading cause of morbidity and mortality in cystic fibrosis patients and immunocompromised individuals. Eradication of Pseudomonas aeruginosa infection is getting more and more difficult due to its increasing resistance to antibiotics. This bacterial strain is characterized by metabolic versatility and ability to acquire multiple resistance mechanisms, which, on its part, leads to high adaptability to variable environmental conditions. It should be noted that prevalence of multidrug-resistant P.aeruginosa strains has been significantly increased during the last two decades; these resistant bacterial strains are responsible for high morbidity and mortality rates, and due to limited therapeutic strategies and inappropriate treatment course, they may be associated with miserable clinical and economic outcomes. As Pseudomonas aeruginosa is considered as a pathogen, posing significant threat to public health due to its ever-increasing prevalence and inefficiency of existing antibacterial agents, Infectious Diseases Society of America (IDSA) has listed it in “ESKAPE” group. The present review discusses intrinsic antibiotic resistance of P.aeruginosa, particularly, the issues related to outer membrane permeability, efflux pump expression and production of antibiotic inactivating enzymes. Herewith, we will talk about antimicrobial peptides and nanoparticles, as alternative treatment options, which may be successfully implemented in clinical practice in the future.