by Amelia Wagoner

Created on: February 26, 2007   Last Updated: May 02, 2007

Pseudomonas aeruginosa is a bacterium that has developed multi-drug resistance in many health care facilities. Resistance has arisen due to a low permeable outer cell membrane and the presence of efflux- pumping mechanisms. It is a problem particularly in patients with cystic fibrosis or burn wounds. Infection if not treated can lead to systemic sepsis which can result in organ failure and death. Currently research is being done to see how to develop an antibiotic that will effectively eliminate the bacterium. Previous research has indicated that preventing the development of a biofilm might help in increasing permeability and increasing access of antibiotics into the cell. The use siderophores conjugated with an antibiotic is also being researched as another possible treatment method.

Introduction
In the last several decades antibiotic resistant microbes have increased in the severity of resistance, especially in health care facilities. Resistant bacteria have become a greater threat because microbes have become not only resistant, but have developed multi-drug resistance. This makes treatment more difficult because it becomes harder to find a remedy that is able to effectively kill the bacteria without also harming uninfected cells. Gram negative Pseudomonas aeruginosa resistant strains are one particular type of bacteria that is becoming a growing problem in hospitals and is a big contributor to nosocomial infections (1). Specifically the bacteria can be found in those with cystic fibrosis and burn wound patients. This resistance can be acquired when exposed to antibiotics, multi-drug resistance to the widely used imipenem and profloxacin specifically, has been observed (2,3). In general these resistance strains of P. aeruginosa do not instantly arise in patients, over time resistance emerges and then becomes more prominent due to certain risk factors that increase the probability of acquiring a resistant strain. Some of these risk factors are long hospital stays which can lead to cross-transmission, the use of broad spectra antibiotics, or exposure to P. aeruginosa that is either susceptible, or resistant to antimicrobials.

Discussion
P. aeruginosa infection is a concern because it can spread throughout the body and cause a systemic inflammatory response, multiple organ failure and death (6). It is hypothesized that the sepsis is caused when P. aeruginosa sheds syndecan 1. Syndecan 1 is a proteoglycan that is attached to the cell surface, when it is cleaved

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