How Can Antimicrobial Resistance in Pseudomonas aeruginosa Be Controlled?

Pseudomonas aeruginosa remains one of the most difficult to treat and to control nosocomial infections. In vitro antimicrobial susceptibility data are required for successful therapy because acquired resistance to such antimicrobials as β-lactams, fluoroquinolones and aminoglycosides is so prevalent in P. aeruginosa. Strategies for controlling P. aeruginosa infections include early detection of P. aeruginosa as the causative pathogen, determination of its antimicrobial susceptibilities, initiation of effective and adequate therapy and strict infection control practice such as hand hygiene and equipment procedures. Once antimicrobial therapy has been initiated against a P. aeruginosa infection, its susceptibility to antimicrobials, especially to carbapenems and fluoroquinolones, should be monitored during antimicrobial therapy to detect clonal shifts in resistance and microbial substitutions as early as possible. Continued surveillance of nosocomial infections and monitoring of antimicrobial resistance by the infection control staff plays major roles in preventing nosocomial infections and the spread of antimicrobial resistance. Additional strategies for controlling antimicrobial resistance in P. aeruginosa include the development of new methods for rapid detection of antimicrobial resistance and new agents and vaccines against P. aeruginosa infections in the laboratories and pharmaceuticals, while preserving the efficacy of currently available antimicrobials for as long as possible in the hospital settings.