RESISTANCE MECHANISMS AND TREATMENT OPTIONS IN RESISTANT PSEUDOMONAS AERUGINOSA STRAINS

Abstract

Among the infections caused by Gram-negative bacteria, Pseudomonas aeruginosa is an important factor, especially in immunocompromised patients. The most important problem against this microorganism that causes infections with high mortality is the emergence of resistant strains. The increasing resistance to antibiotics with the lack of drugs used is an important clinical and public health problem worldwide. This is particularly alarming with multiple drug-resistant (MDR) excessively increased resistance (XDR) and all drug-resistant (PDR) origins more common. This microorganism gains natural resistance to antimicrobials thanks to mechanisms such as external permeability changes, enzymes that inactivate antibiotics and efflux pumps. Multidrug-resistant P. aeruginosa strains are difficult to treat and analysis of pharmacokinetic and pharmacodynamic parameters as well as antibiotic combinations needs to be reviewed to optimize treatment. In this review, it is aimed to summarize the main resistance mechanisms that appear in the laboratory and clinic. Additionally, due to the limited therapeutic agents used in the clinic, it is aimed to discuss potential alternative drugs and new therapeutic options.