SEVERE INFECTIONS CAUSED BY PSEUDOMONAS AERUGINOSA

PERSPECTIVES ON CRITICAL CARE INFECTIOUS DISEASES Jordi Rello, M.D., Series Editor

1. N. Singh and J.M. Aguado (eds.): Infectious Complications in Transplant Recipients. 2000. ISBN 0-7923-7972-1

2. P.Q. Eichacker and J. Pugin (eds.): Evolving Concepts in Sepsis and Septic Shock. 2001. ISBN 0-7923-7235-2

3. J. Rello and K. Leeper (eds.): Severe Community Acquired Pneumonia. 2001. ISBN 0-7923-7338-3

4. R.G. Wunderink and J. Rello (eds.): Ventilator Associated Pneumonia. 2001. ISBN 0-7923-7444-4

5. R.A. Weinstein and M. Bonten (eds.): Infection Control in the ICU Environment. 2002. ISBN 0-7923-7415-0

6. R.A. Barnes and D.W. Warnock (eds.): Fungal Infection in the Intensive Care Unit. 2002. ISBN 1-4020-7049-7

7. A.R. Hauser and J. Rello (eds.): Severe Infections Caused by Pseudomonas Aeruginosa. 2003. ISBN 1-4020-7421-2

SEVERE INFECTIONS CAUSED BY PSEUDOMONAS AERUGINOSA

edited by

Alan R. Hauser, M.D., Ph.D. Departments of Microbiology/Immunology and Medicine

Northwestern University Chicago, IL

USA.

Jordi Rello, M.D., Ph.D. Critical Care Department

Joan XXIII University Hospital University Rovira & Virgili

Tarragona Spain

SPRINGER SCIENCE+BUSINESS MEDIA, LLC

Library of Congress Cataloging-in-Publication Data

A C L P . Catalogue record for this book is available from the Library of Congress. ISBN 978-1-4613-5074-3 ISBN 978-1-4615-0433-7 (eBook) DOI 10.1007/978-1-4615-0433-7 Severe Infections Caused by Pseudomonas Aeruginosa Edited by: Alan R. Hauser and Jordi Rello

Copyright © 2003 by Springer Science+Business Media New York Originally published by Kluwer Academic Publishers in 2003 Softcover reprint of the hardcover 1st edition 2003

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CONTENTS

Contributors

Preface Alan R. Hauser and Jordi Rello

Series Preface Jordi Rello

1. Pseudomonas aeruginosa Infections in Specific Types of Patients and Clinical Settings

2.

3.

4.

5.

6.

7.

8.

Martin E. Stryjewski and Daniel J. Sexton

The Spectrum of Pseudomonas aeruginosa Disease Jorge Roig and Miquel Sabria

Hospital-Acquired Pneumonia Caused by Pseudomonas aeruginosa North American Perspective Grant W. Waterer and Richard G. Wunderink

Hospital-Acquired Pneumonia Caused by Pseudomonas aeruginosa European Perspective Emili Diaz, Jordi Rello, and Jordi Valles

Pseudomonas aeruginosa Infections in Individuals With Cystic Fibrosis North American Perspective Donald J. Davidson, Andrew J. Currie, and David P. Speert

Pseudomonas aeruginosa Infections in Individuals With Cystic Fibrosis European Perspective Montserrat Bosque and Oscar Asensio

Pseudomonas aeruginosa Infections in Cancer Patients Kenneth V. I. Rolston

Treatment of Serious Pseudomonas aeruginosa Infections North American Perspective Pierre Voirol and B. Joseph Guglielmo

v

vii

xi

xiii

17

37

55

71

91

113

127

vi

9.

10.

11.

Treatment of Serious Pseudomonas aeruginosa Infections European Perspective Gert HOffken

Epidemiology and Control of Pseudomonas aeruginosa Infections in the Intensive Care Unit

North American Perspective William R. Jarvis

Epidemiology and Control of Pseudomonas aeruginosa Infections in the Intensive Care Unit European Perspective Daniel Talon and Xavier Bertrand

141

153

169

12. New Perspectives on Prevention and Management of 183 Pseudomonas aeruginosa Infections Kendra P. Rumbaugh, Teiji Sawa, and Jeanine P. Wiener-Kronish

13. Molecular Pathogenesis of Acute Pseudomonas 201 aeruginosa Infections Joanne N. Engel

Index 231

CONTRIBUTORS

Os ear Asensio, M.D. Unidad de Fibrosis Quistica, Alergia y Neumologia Pediatrica Hospital de Sabadell. Corporacio Sanitaria Parc Tauli Sabadell, Spain

Xavier Bertrand, Ph.D. Service d'Hygiene Hospitaliere et d'Epidemiologie Moleculaire Centre Hospitalier Universitaire Besanyon, France

Montserrat Bosque, M.D. Unidad de Fibrosis Quistica, Alergia y Neumologia Pediatrica Hospital de Sabadell. Corporacio Sanitaria Parc Tauli Sabadell, Spain

Andrew J. Currie, BSe., Ph.D. British Columbia Research Institute for Children's and Women's Health University of British Columbia Vancouver, British Columbia, Canada

Donald J. Davidson, M.B.Ch.B., Ph.D. British Columbia Research Institute for Children's and Women's Health University of British Columbia Vancouver, British Columbia, Canada

Emili Diaz, M.D. Critical Care Department Joan XXIII University Hospital Tarragona, Spain

Joanne N. Engel, M.D., Ph.D. Departments of Medicine, Microbiology and Immunology University of California, San Francisco San Francisco, California, USA

viii

B. Joseph Guglielmo, Pharm.D. Department of Clinical Pharmacy, School of Pharmacy University of California San Francisco, California, USA

Gert Hoffken, M.D. Department for Pneumonology University Clinic Carl Gustav Carns Dresden, Germany

William R. Jarvis, M.D. Division of Healthcare Quality Promotion, National Center for Infectious Diseases Centers for Disease Control and Prevention Atlanta, Georgia, USA

Jordi Rello, M.D., Ph.D. Critical Care Department Joan XXIII University Hospital University Rovira & Virgili Tarragona, Spain

Jorge Roig, M.D., Ph.D. Pulmonary Division Hospital Nostra Senyora de Meritxell Escaldes, Andorra

Kenneth V. I. Rolston, M.D. Department of Infectious Diseases, Infection Control and Employee Health The University of Texas M. D. Anderson Cancer Center Houston, Texas USA

Kendra Rumbaugh, Ph.D. Department of Surgery Texas Tech University Health Sciences Center Lubbock, Texas, USA

Miquel Sabria, M.D. Infectious Disease Section Hospital Universitari Germans Trias i Pujol Badalona, Spain

Teiji Sawa, M.D., Ph.D. University of California, San Francisco San Francisco, California, USA

Daniel J. Sexton, M.D. Duke University Medical Center Durham, North Carolina, USA

David P. Speert, M.D. British Columbia Research Institute for Children's and Women's Health University of British Columbia Vancouver, British Columbia, Canada

Martin E. Stryjewski, M.D. Duke University Medical Center Durham, North Carolina, USA

Daniel Talon, Ph.D. Service d'Hygiene Hospitaliere et d'Epidemiologie Moleculaire Centre Hospitalier Universitaire Besan~on, France

Jordi Valles, M.D., Ph.D. Critical Care Department Corporaci6 Sanitaria Parc Tauli Sabadell, Spain

Pierre Voirol, Ph.D. Department of Clinical Pharmacy, School of Pharmacy University of California San Francisco, California, USA

ix

x

Grant W. Waterer, M.B.B.S., F.R.A.C.P., F.C.C.P. Department of Medicine University of Western Australia, Australia

Jeanine P. Wiener-Kronish, M.D. University of California, San Francisco San Francisco, California, USA

Richard G. Wunderink, M.D., F.C.C.P., F.A.C.P. Methodist Healthcare Memphis and University of Tennessee Memphis, Tennessee, USA

PREFACE

Historically, the term monad referred to a basic etiologic unit of infection. In this context, one wonders whether those who named Pseudomonas aeruginosa were uncertain as to the role of this bacterium in disease. Although there is no longer any doubt about P. aeruginosa's virulence, controversy continues to pervade discussions on prevention, diagnosis, and treatment of illness caused by this organism. In this volume of the Perspectives in Critical Care Infectious Diseases Series, an overview of P. aeruginosa disease is given with special emphasis on controversial topics. Many of the topics are covered by both European and North American experts so that the content will reflect a diversity of opinions.

In the first two chapters, an overview of P. aeruginosa disease is presented, while subsequent chapters focus on specific aspects of disease of particular interest. These include the role of P. aeruginosa in hospital­acquired pneumonia, infections in individuals with cystic fibrosis, and infections in cancer patients. Additional chapters discuss the treatment, epidemiology, and control of P. aeruginosa infections. Finally, two chapters are devoted to our evolving understanding of P. aeruginosa pathogenesis and the development of novel therapeutic and preventative interventions.

It is hoped that this book will be a useful resource for both clinicians and scientists who encounter P. aeruginosa during the course of their work. However, recent advances in our understanding of these topics emphasize that it is not so much a final statement as a work in progress.

Alan R. Hauser, M.D., Ph.D. Jordi Rello, M.D., Ph.D. Guest Editors

PERSPECTIVES ON CRITICAL CARE INFECTIOUS DISEASES

An Introduction to the Series

Different models of intensive care medicine have been developed worldwide, involving surgeons, anesthetists, internists and critical care physicians. All intensive care departments of hospitals have in common, the highest incidence of antibiotic consumption, the highest incidence of nosocomial infections and are grouping community-acquired infections with high degrees of severity. Intensive care areas of hospitals have the largest number of infection outbreaks and require differentiated strategies of prevention.

The specific characteristics of the involved population require differentiated approaches in diagnosis and therapy from those required in classical infectious problems. The specific pharmacodynamic conditions of patients requiring mechanical ventilation or continuous renal replacement, require participation of experts in pharmacology.

The specific objective of this Series is to update therapeutic implications and discuss controversial topics in specific infectious problems involving critically ill patients. Each topic will be discussed by two authors representing the different management perspectives for these controversial and evolving topics. The Guest Editors, one from North America and one from Europe, have invited contributors to present the most recent findings and the specific infectious disease problems and management techniques for critically ill patients, from their perspective.

Jordi Rello, M.D., Ph.D. Series Editor