Abstract
Pseudomonas aeruginosa is a bacterial pathogen associated with a wide range of infections and utilizes several strategies to establish and maintain infection including biofilm production, multidrug resistance, and antibiotic tolerance. Multidrug resistance in P. aeruginosa, as well as in all other bacterial pathogens, is a growing concern. Aminoglycoside resistance, in particular, is a major concern in P. aeruginosa infections and must be better understood in order to maintain effective clinical treatment. In this review, the various antibiotic resistance and tolerance mechanisms of Pseudomonas are explored including: classic mutation driven resistance, adaptive resistance, persister cells, small colony variants, phoenix colonies, and biofilms. It is important to further characterize each of these phenotypes and continue to evaluate antibiotic surviving isolates for novel driving mechanisms, so that we are better prepared to combat the rising number of recurrent and recalcitrant infections.
Highlights
Pseudomonas aeruginosa is a Gram-negative, opportunistic, bacterial pathogen associated with a wide range of infections including cystic fibrosis (CF) associated lung disease, post-surgical infections, and chronic wound infections [1–4]
This paper proposed that the alternate metabolism uses phenazines which are produced by the Pseudomonas cells as an alternative electron acceptor due to the lack of available oxygen
Numerous antibiotic tolerant and resistant phenotypes exist in P. aeruginosa, at both the single cell (Fig. 3) and population levels
Summary
Pseudomonas aeruginosa is a Gram-negative, opportunistic, bacterial pathogen associated with a wide range of infections including cystic fibrosis (CF) associated lung disease, post-surgical infections, and chronic wound infections [1–4]. P. aeruginosa has several strategies which it uses to establish and maintain infection including biofilm production, multidrug resistance, and antibiotic tolerance [5–8]. Along with several other bacterial pathogens, multidrug resistance in P. aeruginosa is a growing concern [9–13]. P. aeruginosa has multiple antibiotic resistance and tolerance phe notypes which could allow survival of a bacterial population during antibiotic treatment of an infection. These phenotypes are highly diverse in their mechanisms of development and in the extent to which they are able to survive in the presence of antibiotics. Various resistance and tolerance phenotypes will be summarized in terms of their mechanisms of development and survival despite the presence of antibiotics
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