Pseudomonas Aeruginosa Infection

What is a Pseudomonas infection?

A Pseudomonas infection is an illness that you get from strains (types) of Pseudomonas bacteria. Pseudomonas aeruginosa (P. aeruginosa) is the most common type that causes infections in people. P. aeruginosa most commonly exists in the environment, like in water, plants and soil. But it also appears in moist or wet areas, like bathtubs or sinks. You may also have it on your skin, but it may not cause an infection. Healthcare experts sometimes call this bacterial colonization.

A Pseudomonas aeruginosa infection can be challenging to get rid of. The bacteria have evolved (changed in response to treatments), so certain antibiotics that would typically treat the condition no longer work (antibiotic resistance).

How serious is a Pseudomonas aeruginosa infection?

It depends. It’s rare for a Pseudomonas aeruginosa infection to develop in people with a healthy immune system. But it can be serious and potentially deadly if you have a weakened immune system (immunocompromised). Common causes of a weakened immune system include:

• Autoimmune conditions, such as lupus or rheumatoid arthritis.
• Cancer.
• Cystic fibrosis.
• Diabetes.
• HIV and AIDS.
• Kidney disease.
• Liver disease.
• Organ transplants, such as a heart transplant or lung transplant.
• Pregnancy.
• Severe burns.
• Surgery.

Is Pseudomonas aeruginosa a form of sepsis?

No, Pseudomonas aeruginosa isn’t a form of sepsis. But a Pseudomonas aeruginosa infection can cause sepsis.

Sepsis is a medical emergency in which your immune system stops fighting an infection and starts to attack your healthy tissues and organs. Studies show that P. aeruginosa is a common cause of sepsis in people with severe burns.

What are the types of Pseudomonas aeruginosa infections?

Pseudomonas aeruginosa can cause many different types of infections. These may include:

• Blood infection (septicemia).
• Ear infection.
• Eye infection.
• Lung infection (pneumonia).
• Skin infection (cellulitis).
• Urinary tract infections (UTIs).

It can also cause infections in your gastrointestinal (GI) tract. Your GI tract includes your:

• Mouth.
• Esophagus.
• Stomach.
• Small intestine.
• Large intestine.
• Anus (butthole).

How common are Pseudomonas infections?

Pseudomonas infections are common. In 2017, medical researchers estimated over 32,000 people had a P. aeruginosa infection.

What are the signs and symptoms of a Pseudomonas aeruginosa infection?

Symptoms vary according to where the Pseudomonas aeruginosa infection affects your body. Your symptoms may include:

Blood

• Chills.
• Feeling very tired (fatigue).
• Fever.
• Joint pain.
• Low blood pressure (hypotension).
• Muscle pain.

Ear

• Earache.
• Fluid that comes out of your ear (discharge).
• Itching.
• Swelling.
• Hearing loss.

GI tract

• Headache.
• Diarrhea.
• Nausea and vomiting.

Eye

• Inflammation.
• Pain.
• Pus.
• Red eyes.
• Swelling.
• Sudden vision loss.

Lung

• Chills.
• Cough.
• Difficulty breathing.
• Fever.

Skin

• Discolored (red, brown or purple) bumps.
• Foul-smelling, clear or pink fluid that drains from a wound (draining wound).
• Itchiness.
• White or yellow pus-filled bumps (abscess).

Urinary tract

• Having to pee suddenly or uncontrollably (urge incontinence).
• Leaking pee when you don’t mean to (urinary incontinence).
• Pain around your pelvic area.
• Pain when you pee (dysuria).
• Peeing more than usual (frequent urination).

What causes a Pseudomonas infection?

Many types of bacteria from the genus (grouping) Pseudomonas cause a Pseudomonas infection — the most common type to cause infection is P. aeruginosa. Pseudomonas bacteria can grow and spread in many different ways, including through:

• Water, including from sinks, bathtubs, pools, hot tubs, humidifiers and kitchens.
• Soil.
• Food.
• Contaminated medical devices, including a ventilator or urinary catheter.
• Skin contact.

Is a Pseudomonas aeruginosa infection contagious?

Yes, a Pseudomonas aeruginosa infection can pass from person to person. It usually passes from contaminated surfaces or hands.

Who does a Pseudomonas aeruginosa infection affect?

Pseudomonas aeruginosa bacteria are common. But most people with healthy immune systems are unlikely to get a Pseudomonas aeruginosa infection. You’re more likely to get a Pseudomonas aeruginosa infection if you have a weakened immune system. It’s also common within hospital environments. Some studies suggest that up to 33% of hospital patients may encounter P. aeruginosa.

What are the complications of Pseudomonas aeruginosa infection?

Pseudomonas aeruginosa bacteria can cause a potentially fatal infection that spreads to other areas of your body and triggers other serious conditions, including sepsis and organ failure.

A Pseudomonas aeruginosa infection can also be resistant to antibiotics. That means that common antibiotics that healthcare providers prescribe to treat an infection can’t kill the bacteria. If you take antibiotics to treat a Pseudomonas aeruginosa infection, you may also be more likely to get a Clostridioides difficile (C. diff) infection.

What is the survival rate for a Pseudomonas aeruginosa infection?

Multiyear studies aren’t clear on the survival rate for Pseudomonas aeruginosa infection. Healthcare providers estimate between 39% and 82% of people who have a Pseudomonas aeruginosa infection survive.

How is a Pseudomonas aeruginosa infection diagnosed?

A healthcare provider can diagnose a Pseudomonas aeruginosa infection after reviewing your medical history, asking about your symptoms and conducting a physical examination, which may include:

• Using a stethoscope to listen to your heart and lungs (auscultation).
• Feeling your abdomen.
• Examining your skin.
• Looking at your eyes.

They’ll also order tests to confirm their diagnosis.

What tests will be done to diagnose a Pseudomonas aeruginosa infection?

A healthcare provider may order imaging tests to look for signs of infection in other areas of your body. These tests may include:

• X-rays.
• Ultrasound.
• Magnetic resonance imaging (MRI).
• Computed tomography (CT) scan.

They may also take body fluid or tissue samples and send them to a lab to look for Pseudomonas bacteria.

How is a Pseudomonas aeruginosa infection treated?

A healthcare provider will usually recommend antibiotics to treat a Pseudomonas aeruginosa infection. They may prescribe one or more of the following:

• Aztreonam.
• Carbapenems.
• Ceftazidime.
• Ciprofloxacin.
• Gentamicin.
• Ticarcillin.
• Ureidopenicillins.

You may take these antibiotics orally (as a pill with water), topically (as a cream or gel you apply to your skin), via eye drops or intravenously (through a needle in a vein). You may have to take antibiotics for several weeks or even months, depending on the severity of your infection.

Pseudomonas aeruginosa infections are growing resistant to different types of antibiotics, especially if you get an infection from a hospital or other healthcare facility. It’s very important that you take the antibiotics exactly as your provider prescribes and finish the full course, even if you feel better. If you don’t, a Pseudomonas aeruginosa infection can return and be more challenging to treat.

Carbapenem-resistant Pseudomonas aeruginosa

A small subset of Pseudomonas aeruginosa bacteria is resistant to carbapenem antibiotics (carbapenem-resistant Pseudomonas aeruginosa, or CRPA). They produce carbapenemases. Carbapenemases are enzymes that prevent carbapenem and other beta-lactam (β-lactam) antibiotics from working. Most available antibiotics don’t work against carbapenemase-producing (CP) CRPA. CP-CRPA can share the genetic code for carbapenemases with other bacteria, which rapidly spreads resistance.

Currently, CP-CRPA isn’t common in the United States. Healthcare providers try to limit the spread of infections by identifying multidrug-resistant organisms and working to prevent transmission in the U.S.

Can a Pseudomonas aeruginosa infection go away?

If you don’t have any symptoms or if your symptoms are mild, your Pseudomonas aeruginosa infection will probably go away without treatment.

Serious Pseudomonas aeruginosa infections won’t go away without treatment and can lead to life-threatening complications.

How soon after treatment will I feel better?

If you have a mild Pseudomonas aeruginosa infection, you should start to feel better a few days after starting treatment. It may take weeks or even months to recover after a severe infection.

Can a Pseudomonas aeruginosa infection be prevented?

You can help lower your risk of developing a Pseudomonas aeruginosa infection with the following tips:

• Wash your hands regularly. Washing your hands with antibacterial soap and clean water is the best way to prevent an infection. If you can’t wash your hands, use an alcohol-based hand sanitizer.
• Wash fruits and vegetables. Thoroughly wash fruits and vegetables with clean water and, if possible, a fruit/vegetable soap.
• Drink clean water. If you don’t have clean water available, be sure to drink bottled, canned, boiled or chemically treated water.
• Thoroughly clean surfaces. Use disinfecting products to clean high-touch surfaces.
• Avoid dirty hot tubs and pools. Make sure you regularly treat hot tub or pool water with chlorine.

What can I expect if I have a Pseudomonas aeruginosa infection?

In many cases, the outlook for a Pseudomonas aeruginosa infection is good if you have a healthy immune system. Minor cases usually clear up within a few days with proper treatment. But you must take your entire course of antibiotics. If you don’t, it can be much more challenging to treat.

A Pseudomonas aeruginosa infection can be severe and even fatal if you have a weakened immune system. You may need to take more than one type of antibiotic. And you may need to take the antibiotics over a long period to stop the infection from getting worse.

When should I see a healthcare provider?

Since a Pseudomonas aeruginosa infection can become serious very quickly if you have a weakened immune system, it’s important that you call a healthcare provider right away if you have any signs of an infection or your symptoms don’t improve after treatment.

When should I go to the ER?

Go to the nearest emergency room or call 911 (or your local emergency number) if you have signs of a serious infection, including:

• A high fever (103 degrees Fahrenheit or 39.4 degrees Celsius).
• Confusion.
• Low blood pressure.

What questions should I ask a healthcare provider?

• How did I get a Pseudomonas aeruginosa infection?
• If I don’t have a Pseudomonas aeruginosa infection, what other condition might I have?
• What treatment do you recommend?
• Do I need more than one type of antibiotic?
• What should I do if I forget to take a dose of my antibiotic?
• Are there any signs I should look for that indicate the infection is getting worse?

A note from Cleveland Clinic

Pseudomonas bacteria exist throughout the world in wet environments like water and soil. They may even live on your skin, though they might not cause an infection. If you have a healthy immune system, Pseudomonas aeruginosa infections are usually minor — you may not even notice any symptoms. But the infections can be severe if you have a weakened immune system. Speak to a healthcare provider if you have signs of a Pseudomonas aeruginosa infection. They can diagnose an infection and prescribe the most appropriate antibiotics to manage the bacteria so it doesn’t get worse.