Pseudomonas aeruginosa as an Opportunistic Pathogen

428 Pages·1993·11.387 MB·English

by  Mario Campa (ed.), Mauro Bendinelli (ed.), Herman Friedman (ed.)

Pseudomonas aeruginosa
as an Opportunistic
Pathogen
INFECTIOUS AGENTS AND PATHOGENESIS
Series Editors: Mauro Bendinelli, University of Pisa
Herman Friedman, University of South Florida
COXSACKIEVIRUSES
A General Update
Edited by Mauro Bendinelli and Herman Friedma n
FUNGAL INFECTIONS AND IMMUNE RESPONSES
Edited by Juneann W. Murphy, Herman Friedman, and Mauro Bendinelli
MYCOBACTERIUM TUBERCULOSIS
Interactions with the Immune System
Edited by Mauro Bendinelli and Herman Friedman
NEUROPATHOGENIC VIRUSES AND IMMUNITY
Edited by Steven Specter, Mauro Bendinelli, and Herman Friedman
PSEUDOMONAS AERUGINOSA AS AN OPPORTUNISTIC PATHOGEN
Edited by Mario Campa, Mauro Bendinelli, and Herman Friedman
VIRUS-INDUCED IMMUNOSUPPRESSION
Edited by Steven Specter, Mauro Bendinelli, and Herman Friedman
Pseudomonas aeruginosa
as an Opportunistic
Pathogen
Edited by
Mario Campa
University of Pisa
Pisa, Italy
Mauro Bendinelli
University of Pisa
Pisa, Italy
and
Herman Friedman
University of South Florida
Tampa, Florida
Springer Science+Business Media, LLC
Library of Congress Cataloglng-ln-PublIcation Data
Pseudomonas aeruginosa as an opportunistic pathogen / edited by Mario
Campa, Mauro Bend i ne11i, and Herman Friedman.
p. cm. — (Infectious agents and pathogenesis)
Includes bibliographical references and index.
ISBN 978-1-4613-6324-8 ISBN 978-1-4615-3036-7 (eBook)
DOI 10.1007/978-1-4615-3036-7
1. Pseudomonas aeruginosa infections. 2. Opportunistic
infections. I. Campa, Mario. II. Bendine11i, Mauro.
III. Friedman, Herman. IV.-Series.
[DNLM: 1. Pseudomonas Aeruginosa. 2. Pseudomonas Infections. QW
131 P9735]
QR201.P74P7 1992
616' .0145—dc20
DNLM/DLC
for Library of Congress 92-48759
CIP
ISBN 978-1-4613-6324-8
©1993 Springer Science+Business Media New York
Originally published by Plenum Press in 1993
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
Contributors
DALE R. ABRAHAMSON • Department of Cell Biology, University of
Alabama at Birmingham, UAB Station, Birmingham, Alabama 35294
ANDREW W. ARTENSTEIN • Infectious Disease Service, Department
of Medicine, Walter Reed Army Medical Center, and Department of
Bacterial Diseases, Walter Reed Army Institute of Research, Washing
ton, D.C. 20307-5001
ALI AZGHANI • Department of Biochemistry, University of Texas
Health Science Center at Tyler, Tyler, Texas 75710
FRANCIS BELLI DO • Eli Lilly, 1214 Geneva, Switzerland
RICHARD S. BERK • Department of Immunology and Microbiology,
Wayne State University School of Medicine, Detroit, Michigan 48201
KONRAD BOTZENHART • Department of General Hygiene and Envi
ronmental Hygiene, H ygiene-Institut, University of Tiibingen, D-7400
Tiibingen, Germany
MARIO CAMPA • Department of Biomedicine, Clinical Microbiology
Section, University of Pisa, 56127 Pisa, Italy
MICHAEL S. COLLINS • Miles Pharmaceutical Division, Miles Inc., West
Haven, Connecticut 06516-4175
ALAN S. CROSS • Infectious Disease Service, Department of Medicine,
Walter Reed Army Medical Center, and Department of Bacterial Dis
eases, Walter Reed Army Institute of Research, Washington, D.C.
20307 -5001
STANLEY J. CRYZ, JR. • Swiss Serum and Vaccine Institute, CH-3001
Berne, Switzerland
v
VI CONTRIBUTORS
GERD DORING • Department of General Hygiene and Environmental
Hygiene, Hygiene-Institut, University of Tiibingen, D-7400 Tiibingen,
Germany
DARRELL R. GALLOWAY • Department of Microbiology, The Ohio
State University, Columbus, Ohio 43210-1292
ROBERT E. W. HANCOCK • Department of Microbiology, University of
British Columbia, Vancouver, British Columbia, Canada V6T lW5
LOUIS W. HECK • Department of Medicine, Veterans Administration
Medical Center, University of Alabama at Birmingham, UAB Station,
Birmingham, Alabama 35294
JANEL HECTOR • Department of Biochemistry, University of Texas
Health Science Center at Tyler, Tyler, Texas 75710
IAN ALAN HOLDER • Shriners Burns Institute, Cincinnati, Ohio
45229-3095
RANDALL T. IRVIN • Department of Medical Microbiology and Infec
tious Diseases, University of Alberta, Edmonton, Alberta, Canada
T6G 2H7
ALICE JOHNSON • Department of Biochemistry, University of Texas
Health Science Center at Tyler, Tyler, Texas 75710
FRED JOSEPH, JR. • Department of Pediatrics, Louisiana State Univer
sity Medical Center, New Orleans, Louisiana 70112
ANTONELLA LUPETTI • Department of Biomedicine, Clinical Micro
biology Section, University of Pisa, 56127 Pisa, Italy
PAOLA MARELLI • Department of Biomedicine, Clinical Microbiology
Section, University of Pisa, 56127 Pisa, Italy
RANDAL E. MORRIS • Department of Anatomy and Cell Biology, Uni
versity of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0521
GERALD B. PIER • Channing Laboratory, Department of Medicine,
Brigham and Women's Hospital, Harvard Medical School, Boston, Mas
sachusetts 02115-5899
CATHARINE B. SAELINGER • Department of Molecular Genetics, Bio
chemistry, and Microbiology, University of Cincinnati College of Medi
cine, Cincinnati, Ohio 45267-0524
CHRISTINE M. SHUMARD • Diagnostics Division, Abbott Laborato
ries, Abbott Park, Illinois 60064
CONTRIBUTORS Vll
RICARDO U. SORENSEN • Department of Pediatrics, Louisiana State
University Medical Center, New Orleans, Louisiana 70112
DAVID P. SPEERT • Departments of Pediatrics and Microbiology and the
Canadian Bacterial Diseases Network, University of British Columbia,
and Division of Infectious and Immunological Diseases, British Colum
bia's Children's Hospital, Research Centre, Vancouver, British Columbia,
Canada V5Z 4H4
ROBERT STEADMAN • Institute of Nephrology, Cardiff Royal Infirm
ary, Cardiff, Wales CF2 ISZ
DONALD E. WOODS • Department of Microbiology and Infectious Dis
eases, University of Calgary Health Sciences Centre, Calgary, Alberta,
Canada T2N 4Nl
DANIEL J. WOZNIAK • Department of Microbiology and Immunology,
University of Tennessee, Memphis, Tennessee 38163
Preface
This volume is devoted to Pseudomonas aeruginosa as an "opportunistic"
pathogen in humans. We have attempted to provide balanced coverage of
epidemiology, pathogenesis, clinical features, and control measures. All the
chapters have been contributed by outstanding authorities on specific aspects
of P. aeruginosa research. This book should prove useful to physicians and
surgeons who have in their care patients infected, or at risk of becoming
infected, with P. aeruginosa and who want to gain a greater understanding of
this elusive microorganism, the diseases it produces, and means of control.
We also hope that the book will stimulate further studies on the mechanisms
whereby P. aeruginosa establishes itself and causes disease in compromised
patients.
The opportunistic behavior of this bacterium was recognized a long time
ago. Since then, the extent of our knowledge about P. aeruginosa and microbes
in general has burgeoned. Nevertheless, there are still few real clues as to why
P. aeruginosa infection is much less common than one would expect consider
ing the wide distribution of this bacterium in nature and why it mainly infects
individuals whose local or systemic antibacterial defenses are compromised.
Because of its minimal growth requirements and nutritional flexibility, P.
aeruginosa is particularly able to adapt to changing ecological conditions. It is
also capable of surviving for long periods, especially in moist environments.
In addition, the poor permeability of its outer membrane makes it intrin
sically resistant to many disinfectants and antimicrobial agents, and it is
therefore well adapted to compete with antibiotic-secreting microorganisms
in its natural ecosystem, the soil, and to exploit the selective advantages
provided by hospital environments.
Understanding why in healthy humans-in spite of the large variety of
virulent factors produced by the microorganism-the carrier state is gener
ally rare and unstable and, in contrast, infection of the immunocompromised
IX
x PREFACE
is common and severe is not only a challenge per se but may also help shed
light on opportunistic microorganisms in general. The number of immuno
compromised individuals has exploded worldwide as a consequence of pro
gresses in modern medicine and, more recently, the epidemic of acquired
immunodeficiency syndrome. There is a consensus that this population
"class" will increase considerably in the next few decades. This will not only
expand the number of potential victims of opportunistic infections but may
also provide new opportunities for pseudomonads and other agents to
gradually adapt better to the human host. New knowledge may help reduce
such risks.
We are grateful to the excellent scientists who provided enthusiastic
support for the preparation of this volume, and we are confident that their
collective effort will be appreciated by the reader.
Mario Campa
Mauro Bendinelli
Herman Friedman
Contents
1. Ecology and Epidemiology of Pseudomonas aeruginosa
KONRAD BOTZENHART and GERD DORING
1. Introduction ............................................. 1
2. Ecology.................................................. 2
2.1. Adaptability ........................................ 2
2.2. Inanimate Environment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2.3. Healthy Humans .................................... 6
3. Epidemiology ............................................ 7
3.1. Incidence of Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3.2. Routes of Transmission .............................. 7
4. Resume.................................................. 12
References ............................................... 13
2. Attachment and Colonization of Pseudomonas aeruginosa: Role of
the Surface Structures
RANDALL T. IRVIN
1. Introduction ............................................. 19
2. Role of Adherence in Pathogenesis. . . . . . . . . . . . . . . . . . . . . . . . . . 20
2.1. Morphology of Adherence to Human Respiratory Cells. . 21
2.2. Effect of Epithelial Cell Type on Adherence. . .. . . . . . . . . 21
3. Adhesins................................................. 22
3.1. Structure and Function of the Capsule . . . . . . . . . . . . . . . . . 23
3.2. Exoenzyme S ....................................... 28
3.3. Structure of Pili ..................................... 29
Xl