Evolving epidemiology of Pseudomonas aeruginosa infections.

The dramatic increase in infections caused by Pseudomonas aeruginosa over the last three decades is examined in this review. By virtue of its unique growth characteristics, this organism occupies a firm niche in the hospital environment where it continues to be a major nosocomial pathogen, with particularly high rates of infection in traditionally susceptible patient subpopulations: the compromised host, patients with malignancy, cystic fibrosis, burn wounds and trauma. In recent years infection with Pseudomonas aeruginosa has become more prominent in other patient subpopulations: for example, post-surgical, pediatric and dialysis patients, as well as the elderly. A more interesting evolution in the epidemiology of infections caused by Pseudomonas aeruginosa is the appearance, often anecdotal, of new manifestations in healthy, non-hospitalized hosts e.g. the water-associated syndromes, puncture wounds, drug addiction. The need for better data on the prevalence of these infections, the required host-organism interactions and their practical impact sets an agenda for future investigation.