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Pseudomonas spp. - Pathogen Safety Data Sheets - Public Health Agency of Canada
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PSEUDOMONASSPP.
PATHOGENSAFETYDATASHEETINFECTIOUSSUBSTANCES
SECTIONIINFECTIOUSAGENT
NAME: Pseudomonasspp. SYNONYMORCROSSREFERENCE: P.aeruginosa,P.stutzeri,P.fluorescens

Footnote Footnote

CHARACTERISTICS:Thegenus Pseudomonas,ofthe Pseudomonadaceaefamily,aremotilegram negativeaerobicbacteria,24mlongplumpshapedrods,withpolarflagellawhichhaveanimportant roleinpathogenicity 1 3 .Theyarenonsporeformingandcanproducepigments,suchaspyocyanine (greenblue)andpyorubrin(yellowgreen)fluorescence 1 , 4 7 . P.aeruginosacanproducealarge varietyofextracellulartoxins,includingexotoxinAandenterotoxins 8 .Othersubstancessuchas hydrocyanicacid,proteolyticenzymes,toxicsurfaceslime,andhaemolyticsubstancesmayalso contributetothepathogenicityofthisspecies.Toxinscombinedwithharmfulsubstancesare determinantfactorsinthehighvirulenceof P.aeruginosainavarietyofdifferenthosts 9 .

SECTIONIIHAZARDIDENTIFICATION
PATHOGENICITY/TOXICITY :Asopportunisticpathogens, Pseudomonasspp.ofteninvadesthehost tissueandcauseinfectionandbacteremiainimmunocompromisedhosts(e.g.,HIV/AIDS,cysticfibrosis, bronchiectasis,andseverechronicobstructivepulmonarydisease,burns,malignancy,ordiabetes mellitus) 10 , 11 .Thecommonsiteofinfectionisthelowerrespiratorytract,andseverityrangesfrom colonizationwithoutimmunologicalresponsetoseverenecrotizingbronchopneumoniasuchsevere infectioninpatientswithcysticfibrosisisalmostimpossibletoeradicateonceestablishedintheairways 12 .Pseudomonalpneumoniaoftendevelopsfromoropharyngealcontaminationorsecondary bacteremia,andisalsoacommoncauseofnosocomialventilatorrelatedpneumoniainintensivecare settings.Infectionsalsoincludeendocarditis,osteomyelitis,urinarytractinfections,gastrointestinal infections,meningitis,and,commonly,septicaemia 13 . P.aeruginosaisthemostcommonagent associatedwithinfectionandinflammationduringcontactlenswear.Thebacteriacolonizeonlensesand produceproteasestokillorinvadecornealcells,aninfectionthatcanleadtoscarringandvisionloss 1 . Thespeciesisalsothemostvirulentwithamortalityrateof30%,whichcanbehigherdependingon predisposingconditions 4 . P.aeruginosacanalsoreadilycolonizeonopenburnwounds,causing infections,abscesses,andsepsis,withedemaand/ordiscolorationofunburnedskinatwoundmargins andgreenpigmentinsubcutaneousfat 14 , 15 . P.aeruginosaisalsoassociatedwithswimmersear (otitisexterna).Other Pseudomonasspeciesarealsoopportunistichowever,casesofinfectionarerare 3. EPIDEMIOLOGY :Worldwideoftenaprobleminhospitalsasitcanbefoundonequipment,increasing theriskofnosocomialinfections 12 .3040%ofthosewithcysticfibrosiswillacquirechronic pseudomonalinfection. P.aeruginosainfectionsaccountfor20%ofpneumoniaand16%ofurinarytract infections 16 .Prevalenceinthecommunityislessthaninthehospital,andcasesofseverecommunity acquiredinfectionarerare 17 . HOSTRANGE:Humans,animals(wild,domestic,livestock),andplants(floraandfungi) 18 . INFECTIOUSDOSE:Unknownforhumans.Studieswithlarvaemodelshavefoundtheinfectiousdose fortheinsectstobehigh 19 . MODEOFTRANSMISSION: P.aeruginosahavebeenfoundtosurvivewithindropletnucleiandcan
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Pseudomonas spp. - Pathogen Safety Data Sheets - Public Health Agency of Canada

remaininaerosolsforlongperiodsoftime,thusthereisevidenceofpotentialairbornetransmission 20 .Contactwithcontaminatedwaterisalsoamajorroute,butsincetheoralinfectiousdoseisthought tobeveryhigh,routesthatposethegreatesthealthriskareskinexposure(forexample,in contaminatedhottubwater)andlungexposurefrominhalingaerosolsdischargedfrominfected respiratorytracts 13 .Thebacterialcanoftenenterthebodythroughinjuriesandwounds 3 .Theuseof contaminatedmechanicalrespiratoryventilatorsinhospitalsettingsisalsoacommonsourceof nosocomialinfections 12 . INCUBATIONPERIOD:Variesaccordingtoinfection,eyeinfectioncanappear2472hoursafter infection 21 . COMMUNICABILITY :Spreadofinfectionfrompersontopersonisspeculatedtobehighlypossible duringinfection,especiallyamongstcysticfibrosispatients 22 .

SECTIONIIIDISSEMINATION
RESERVOIR:Infectedhumans,animals,contaminatedwater,soil 18 . Pseudomonasspp.areubiquitous intheenvironment. ZOONOSIS:None. VECTORS:None.

SECTIONIVSTABILITYANDVIABILITY
DRUGSUSCEPTIBILITY : Pseudomonasspp.areresistanttomanyantibiotics.Susceptibilityto extendedspectrumpenicillins(suchasticarcillin,azlocillin,andpiperacillin),aminoglycosides, cephalosporins,fluoroquinolones,polymixins,andthemonobactams 12 . DRUGRESISTANCE:Multidrugresistantstrainsareemerging,suchasagainstcarbenicillin, cephalosporins,ceftazidime,andciprofloxacin 12 . SUSCEPTIBILITYTODISINFECTANTS:Susceptibilityhasbeenshownfor1%sodiumhypochlorite, 70%ethanol,2%glutaraldehyde,andformaldehyde 23 however,ithasbeenfoundtoberesistantto disinfectantsthatareusedtotreatdrinkingwatersuchaschlorine,chloramines,ozone,andiodine 13 . Certainadaptedstainshavebeenfoundtobeabletogrowindisinfectantshowever,isopropylalcohol 4%v/vorethylalcohol6%v/vareeffectivedisinfectants 24 . PHYSICALINACTIVATION:Inactivationandsterilizationusingmoistheatshouldbeat121Cfor15 minutesorlonger,dryheatat170250Corhigherfor30minutesormore 25 . SURVIVALOUTSIDEHOST: Pseudomonascansurviveformonthsondrysurfacesandinanimate objects,andareoneofthebacteriamostfrequentlyisolatedfrompatientswithnosocomialinfections humiditycanimprovepersistence 26 .Growthobservedindistilledwatercansurviveuptomonthswith minimalnutrients 27 .

SECTIONVFIRSTAID/MEDICAL
SURVEILLANCE:Diagnosisismadebybacteriologicalcultureonselective/nonselectiveculturemedia andlaboratoryidentification 28 . FIRSTAID/TREATMENT:Administerappropriatedrugtherapy.Aminoglycosidewithlactampenicillin isusuallythefirstlineoftreatment 12 .Aggressivetreatmentcanavoiddevelopmentofchronic infection.Woundsshouldbecleanedwithsurgicaldetergentdisinfectantsand/ortopicalantibacterial ointments,suchasmupirocin 15 . IMMUNIZATION:Nonecurrentlyavailable,althoughstudieshaveshownthatliveattenuated P. aeruginosavaccinesinmicecanprotectagainstcornealinfections 15 . PROPHYLAXIS:Antibioticssuchasciprofloxacin(afluoroquinolone)canbeusedinpatientswithCF, butconstantprophylactictherapyisnotrecommendedasitcanleadtodrugresistance 12 .
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Pseudomonas spp. - Pathogen Safety Data Sheets - Public Health Agency of Canada

SECTIONVILABORATORYHAZARDS
LABORATORYACQUIREDINFECTIONS:Nonereportedtodate. SOURCES/SPECIMENS:Bloodcultures,urine,skin,sputum,softtissuesamples,lowerrespiratory tractsecretions,woundexudates,contaminatedwatersamples,andmechanicalventilatorequipment
4 , 12 , 14 , 27 , 28

PRIMARYHAZARDS:Accidentalparenteralinoculation,inhalationofinfectiousaerosols,accidental ingestion,ordirectskincontact 4 , 13 , 20 . SPECIALHAZARDS:None.

SECTIONVIIEXPOSURECONTROLS/PERSONALPROTECTION
RISKGROUPCLASSIFICATION:RiskGroup2.Thisriskgroupappliestothegenusasawhole,and maynotapplytoeveryspecieswithinthegenus. CONTAINMENTREQUIREMENTS:ContainmentLevel2facilities,equipment,andoperationalpractices forworkinvolvinginfectiousorpotentiallyinfectiousmaterials,animals,orcultures.Thesecontainment requirementsapplytothegenusasawhole,andmaynotapplytoeachspecieswithinthegenus. PROTECTIVECLOTHING :Labcoat.Gloveswhendirectskincontactwithinfectedmaterialsoranimals isunavoidable.Eyeprotectionmustbeusedwherethereisaknownorpotentialriskofexposureto splashes 29 . OTHERPRECAUTIONS:Allproceduresthatmayproduceaerosols,involvehighconcentrationsorlarge volumesshouldbeconductedinabiologicalsafetycabinet(BSC).Theuseofneedles,syringes,and othersharpobjectsshouldbestrictlylimited.Additionalprecautionsshouldbeconsideredwithwork involvinganimalsorlargescaleactivities 29 .

SECTIONVIIIHANDLINGANDSTORAGE
SPILLS:Allowaerosolstosettleand,wearingprotectiveclothing,gentlycoverspillwithpapertowels andapplyanappropriatedisinfectant,startingattheperimeterandworkingtowardsthecentre.Allow sufficientcontacttimebeforecleanup 29 . DISPOSAL:Decontaminateallwastesthatcontainorhavecomeincontactwiththeinfectiousorganism beforedisposingbyautoclave,chemicaldisinfection,gammairradiation,orincineration 29 . STORAGE:Theinfectiousagentshouldbestoredinleakproofcontainersthatareappropriatelylabelled 29 .

SECTIONIXREGULATORYANDOTHERINFORMATION
REGULATORYINFORMATION:Theimport,transport,anduseofpathogensinCanadaisregulated undermanyregulatorybodies,includingthePublicHealthAgencyofCanada,HealthCanada,Canadian FoodInspectionAgency,EnvironmentCanada,andTransportCanada.Usersareresponsibleforensuring theyarecompliantwithallrelevantacts,regulations,guidelines,andstandards. UPDATED:December2011 PREPAREDBY :PathogenRegulationDirectorate,PublicHealthAgencyofCanada Althoughtheinformation,opinionsandrecommendationscontainedinthisPathogenSafetyDataSheet arecompiledfromsourcesbelievedtobereliable,weacceptnoresponsibilityfortheaccuracy, sufficiency,orreliabilityorforanylossorinjuryresultingfromtheuseoftheinformation.Newly discoveredhazardsarefrequentandthisinformationmaynotbecompletelyuptodate. Copyright PublicHealthAgencyofCanada,2011 Canada

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Pseudomonas spp. - Pathogen Safety Data Sheets - Public Health Agency of Canada

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Clifton,I.J.,&Peckham,D.G.(2010).Definingroutesofairbornetransmissionof Pseudomonasaeruginosainpeoplewithcysticfibrosis.ExpertReviewofRespiratory Medicine,4(4),519529.doi:10.1586/ers.10.42 Ziady,L.E.,&Small,N.(Eds.).(2004). PreventandControlInfection.CapeTown,South Africa:JudaandCoLtd. Speert,D.P.,Campbell,M.E.,Henry,D.A.,Milner,R.,Taha,F.,Gravelle,A.,Davidson,A. G.,Wong,L.T.,&Mahenthiralingam,E.(2002).EpidemiologyofPseudomonasaeruginosain cysticfibrosisinBritishColumbia,Canada.AmericanJournalofRespiratoryandCriticalCare Medicine,166(7),988993. LaboratorySafetyManual (1993).(2nded.).Geneva:WorldHealthOrganization. Burdon,D.W.,&Whitby,J.L.(1967).Contaminationofhospitaldisinfectantswith Pseudomonasspecies.BritishMedicalJournal,2(5545),153155. Nail,S.L.,&Akers,M.J.(Eds.).(2002). DevelopmentandManufactureofProtein Pharmaceuticals.NewYork,NY,USA:KluwerAcademic/PlenumPublishers. Kramer,A.,Schwebke,I.,&Kampf,G.(2006).Howlongdonosocomialpathogenspersiston inanimatesurfaces?Asystematicreview.BMCInfectiousDiseases,6,130.doi:10.1186/1471 23346130 Leung,D.K.C.,Mok,W.F.M.,Yu,D.M.W.,&Au,T.C.(2001).Useofdistilledwhitevinegar dressingsupplementaltooralantibioticsinthemanagementof Pseudomonasaeruginosaexit siteinfectionincontinuousambulatoryperitonealdialysispatients.HongKongJournalof Nephrology,3(1),3840. Xu,J.,Moore,J.E.,Murphy,P.G.,Millar,B.C.,&Elborn,J.S.(2004).Earlydetectionof Pseudomonasaeruginosacomparisonofconventionalversusmolecular(PCR)detection directlyfromadultpatientswithcysticfibrosis(CF).AnnalsofClinicalMicrobiologyand Antimicrobials,3,21.doi:10.1186/14760711321 PublicHealthAgencyofCanada.(2004).InBestM.,GrahamM.L.,LeitnerR.,OuelletteM. andUgwuK.(Eds.), LaboratoryBiosafetyGuidelines(3rded.).Canada:PublicHealthAgency ofCanada.

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