 Welcome back to our meds smarter lecture series where we're taking a smarter approach to preparing future physician Before we get started if you'll take just a quick minute and click that like button and also Subscribe and turn the bell on so that you'll be notified when we post new videos Let's talk about pseudomonas aeruginosa, which is another gram negative Let's break down that aeruginosa Latin that Originosa we can think of that as aerobic All right, so this means that it has to be in the presence of oxygen somehow. Okay, this is motile So it can move it is a catalyst positive Gram negative rod so you see in this picture here. It's not a very clear picture, but we are seeing that red color stain Indicating that it is gram negative It does not ferment lactose and it is oxidase positive So we often see pseudomonas and water a lot of times in soil also It's fairly easy to tell if someone has an infection with pseudomonas because of its odor The odor is grape like this is probably a buzzword that you can use for Pseudomonas if they talk about a patient having An infection on a leg and the wound is you know They'll describe the wound and they'll talk about how it has an odor that smells like grapes That's a great buzzword for pseudomonas infections So what all type of symptoms do we have with pseudomonas? Well, pseudomonas actually in and of itself can be a mnemonic to help you remember what different symptoms that it causes so Pseudomonas spelled out can be pneumonia sepsis ecthyma gangrenosum UTIs Diabetes osteomyelitis mucoid polysaccharide capsule otitis externa or swimmers ear nosocomial infections addicts and skin infections So remember all of those particular things associated with pseudomonas that can be Present here. So let's break down a couple of these specifically the muco polysaccharide capsule This is what helps cause chronic pneumonia in patients that have cystic fibrosis because it actually forms a biofilm That biofilm is very difficult to get rid of and that's where we can have chronic pneumonia Even though we can give antibiotics and kill some of that bacteria that biofilm is much more difficult to get rid of Pseudomonas also produces peep which is a phospholipase C that degrades the cell membranes So that's the P in peep the E in peep is an endotoxin that endotoxin can give us a fever and shock The second E is an exotoxin a that exotoxin a specifically will come in and activate the EF2 cascade And then the final P is pigments So pyoviridine and pyosinan are going to be present in Pseudomonas, that's what gives it a characteristic blue-green pigment. So if you see patients that they describe a Wound on the leg or on the arm or somewhere on the body on the skin That has a blue-green pigment and it smells like grapes then this is diagnostic of Pseudomonas for us It can also cause corneal ulcers and keratitis of specifically for those patients that wear contact lenses Not just necessarily contact lenses, but that they have contact lenses that they consistently wear without taking them out That's why it's important to Educate your patients that wearing contact lenses 24 seven three sixty five and never taking them out to give your eye the chance to breathe And and get rid of some of these potential infections is very important We don't want to keep contact lenses in all the time because of things like Pseudomonas Keratitis there minor eye trauma can also cause some of that too if it gets infected with that particular bacteria So we also mentioned a minute ago that ecthyma gangrenosum. What is that? That is a necrotic Cutaneous lesion that's caused by Pseudomonas. You can see here in this picture. It's a little small, but there's some Lesions here on this individual patient all over the legs here So that is a rapidly progressive necrotic lesion there caused by Pseudomonas and it's labeled as ecthyma gangrenosum Oftentimes we see these in patients that are immunocompromised So how do we treat Pseudomonas? We're gonna treat Pseudomonas with campfire drugs. Okay campfire is another mnemonic that we can use here that's going to spell out Carbapenems for the C the A is amino glycosides the M is mono-bactams The P is polymixin so polymixin B or co-listen. This is also known as polymixin E The F in campfire is fluoroquinolones. These are going to be like ciprofloxacin or levofloxacin The I and the R are kind of mixing This is just a little bit of a way to get this mnemonic to work But third and fourth generation cephalosporins so cephtazidine and cephapeme are two of your main ones that work very well for Pseudomonas and then finally the E in campfire is your extended spectrum penicillins like Pipericillin and tickericillin If you found this material helpful for your studying, please like and consider subscribing to the channel Also share this video so that more people can benefit from it like you have