MMI 301-L15 -

Pseudomonas & Acinetobacter

Dr. Janita Pinto

11/20/21

www.gmu.ac.ae COLLEGE OF MEDICINE

Learning Objectives

On completion of this unit, the student will be able to:

• Explain the salient features of Pseudomonas & Acinetobacter

• Describe the pathogenesis and clinical features of
Pseudomonas & Acinetobacter
• Explain laboratory diagnosis of Pseudomonas aeruginosa &
Acinetobacter.
• Enlist the choice of treatment to those organisms.
 Pseudomonas aeruginosa

General characteristics
• Obligate aerobe

• Small gram-negative motile rods with a single polar flagellum,

• Common inhabitant of soil & water (ubiquitous-wide spread)

• Grapelike odor

• Produces two pigments

(1) Pyocyanin, which can color the pus in a wound blue, and (2)

Pyoverdin (fluorescein), a yellow-green pigment that fluoresces under
ultraviolet light
 Pseudomonas aeruginosa

General characteristics
• Oxidase & catalase positive

• Metabolism -oxidative and non -fermentative

• Resistant to soaps, dyes, quaternary ammonium disinfectants, drugs, drying

• Frequent contaminant of ventilators, IV solutions, anesthesia equipment

• OPPORTUNISTIC PATHOGEN
 Pathogenicity
•Common cause of NOSOCOMIAL INFECTIONS in hosts with

burns, neoplastic disease, cystic fibrosis

•P. aeruginosa causes infections at almost all sites in the body but

shows a rather strong predilection for the lungs

•Acute Pneumonia (especially in cystic fibrosis patients)

-Respiratory infections are the most common of all infections

caused by P. aeruginosa. It is an important cause of hospital-

acquired pneumonia, especially in those undergoing mechanical

ventilation (ventilator-associated pneumonia). 

 Pathogenicity

•Bacteremia - distinctive skin lesions (ecthyma

gangrenosum) which occur almost exclusively in

markedly neutropenic patients and patients with

AIDS

•UTI, Wound infections – especially in burn

victims

•Blue pus
 Pathogenicity
•Infective endocarditis - IV drug users

•Eye infections-Keratitis and corneal ulcers are the most common types of eye disease and are

often associated with contact lenses 

•Ear infections (otitis) - suppurative otitis , “swimmer’s ear”

•In debilitated patients can cause- endocarditis, meningitis, septicemia

•Skin and Soft Tissue Infections - Multiple outbreaks have been linked to whirlpools, spas,

and swimming pools

•Shanghai fever - a community-acquired enteric illness associated with sepsis

•Infantile diarrhea

MULTI DRUG RESISTANT

Pathomechanisms
• Adhesion
• Pili, flagella and fimbriae
• Invasion
• Extracellular enzymes and toxins
• Dissemination
• Leukocidin inhibits neutrophils und leukocytes
• LPS (Endotoxin)
• Protection
• Capsule
 Lab Diagnosis
Specimens Urine, pus, sputum, CSF, blood, skin swab according to
the type of infection

Gram Stain: Gram-negative bacilli

Culture: MacConkey's agar :

Fruity aroma Non lactose fermenter
Nutrient Agar

Cetrimide agar
Identification tests TSI Agar (Selective media)

Oxidase +ve

11/20/2021
 Acinetobacter baumannii
Important Properties
• Acinetobacter species are small coccobacillary gram-negative bacilli found
commonly in soil and water, but they also colonize the skin and upper
respiratory tract.
• They are opportunistic pathogens
Disease
• Acinetobacter baumannii causes disease chiefly in a hospital setting usually
associated with respiratory therapy equipment (ventilator-associated
pneumonia) and indwelling catheters.
• Pneumonia and urinary tract infections are the most frequent manifestations.
Transmission
• Respiratory route is prominent route of entry
 Acinetobacter baumannii

Virulence factors
• OmpA, a member of the Outer membrane proteins (OMPs), has
been determined to contribute significantly to the disease causing
potential
• Ability of A. baumannii to form biofilms
• Phospholipase D and C
• Fimbriae
Acinetobacter baumannii
Laboratory Diagnosis
• Gram stain- gram-negative bacilli
• Culture- sheep blood agar, MacConkey agar
• Biochemical tests- Nonmotile, Oxidase negative, Nitrate negative
Catalase positive, Nonfermentative.
Treatment
• Imipenem is the drug of choice. Colistin is useful in carbapenem-
resistant strains.
Prevention
• There is no vaccine
Learning Resources
• Murray PR, Rosenthal KS, Pfaller MA . Medical Microbiology. 8th ed.
Elsevier Ltd; 2016. ISBN: 978-0-323-29956-5.
https://www.clinicalkey.com/#!/content/book/3-s2.0-B97803232995650
0080X

• Barer MR, Irving W, Swann A, Perera N. Medical Microbiology: A

Guide to Microbial Infections. 19th Ed. Elsevier Ltd; 2018, ISBN: 978-
0-7020-7200-0.
https://www.clinicalkey.com/#!/content/book/3-s2.0-B97807020720000
00023
Additional Reading
• Levinson W. Review of Medical Microbiology and Immunology. 14th
11/20/2021
ed. USA. McGraw Hill; 2014. ISBN-13: 978-007-1818-117.