Pseudomonas aeruginosa: infection symptoms, treatment and who is at risk

nidirect says infections caused by Pseudomonas are usually treated using a suitable antibiotic in hospital. If screening shows you have a Pseudomonas infection you will be contacted and your treatment will be discussed with you. Hospital staff take special precautions with patients who have Pseudomonas to stop it spreading.

UKHSA notes that P. aeruginosa is resistant to many commonly used antibiotics. This is why laboratory testing of a swab, urine or blood sample matters: it shows which antibiotics will work against the particular strain. The antibiotic, route and length of treatment depend on the site and severity of the infection, so there is no single standard course.

Colonisation is different from infection. nidirect explains that Pseudomonas may be found on the skin of some people without causing infection. A risk assessment is carried out, and treatment may be given in some cases if the person is at risk of developing an infection. Otherwise the bacterium may not need treatment.

There is no single set of symptoms. nidirect says Pseudomonas can cause a variety of infections, and the symptoms depend on which part of the body is affected. A temperature is mentioned as a sign of infection in people with a weakened immune system.

• Pneumonia (chest infection): cough, breathlessness and fever

• Urinary tract infection: urinary symptoms such as pain passing urine

• Wound infection: a wound that becomes red, painful or discharges

• Septicaemia (blood infection): a very unwell person, often with fever

• Infection of the gastro-intestinal system

UKHSA describes P. aeruginosa as a Gram-negative bacterium often found in soil and ground water. It is an opportunistic pathogen, which means that it rarely affects healthy individuals but can cause a wide range of infections in people with a weakened immune system.

nidirect says it is a tough bacterial strain able to survive in harsh environments, which makes it difficult to get rid of completely. For that reason, infection control departments in hospitals are constantly taking measures to prevent spread and outbreaks.

It can be passed on, particularly in healthcare settings, which is why hospitals take precautions. UKHSA says that in hospitals the organism can contaminate devices that are left inside the body, such as respiratory equipment and catheters, and that infections are sometimes associated with contact with contaminated water.

For healthy people outside hospital the risk is low, because nidirect says it rarely causes illness outside a hospital or healthcare setting. The practical steps are those for any germ: nidirect advises washing hands regularly with soap and water, particularly after the toilet and before eating, using liquid rather than bar soap, not using flannels or nail brushes, and not sharing towels and flannels.

• Stay at home until at least 48 hours after symptoms have cleared if you are ill

• Clean toilet seats, flush handles, light switches and door handles with a bleach-based cleaner after each use if there is contamination

• Wash contaminated clothes and sheets separately at the highest possible temperature

• Wash hands with liquid soap and water when entering and leaving hospital wards

• Avoid visiting hospital if you are feeling unwell and avoid taking children under 12

nidirect says that if you have a weakened immune system, particularly if you are very young or older, you can be at risk. It rarely causes infection in people in good health and is more likely to infect patients who are already sick. It lists people who have HIV, people with cancer, people with severe burns, people with diabetes and people with cystic fibrosis. UKHSA gives a similar list and also names newborns.

Pseudomonas in children with a weakened immune system is treated in the same way, and nidirect says that if your child has a weakened immune system and develops signs of infection you should seek medical advice urgently.

nidirect explains that during pregnancy a woman's body undergoes changes promoted by hormones, including changes to the immune system, which promote a healthy pregnancy and help protect the developing baby. As a result, pregnant women can be more likely to experience some infections, such as urine infections, and may have an increased risk of getting a Pseudomonas infection.

If you are pregnant and have symptoms of infection such as a temperature or urinary symptoms, tell your midwife or GP promptly so the cause can be investigated.

UKHSA has published guidance because Pseudomonas aeruginosa is a recognised cause of perichondritis after ear piercing, an infection of the skin and tissue covering the cartilage of the outer ear. It says the bacteria naturally live in water and can be transferred to the piercing site from water or from items made up with water, such as green soap, disinfectant or aftercare saline solutions.

UKHSA explains that piercing creates a breach in the skin and can damage the cartilage, allowing bacteria in. If a new cartilage piercing becomes very painful, swollen or red, get it checked promptly by a GP or pharmacist.

nidirect says that if you or your child have a weakened immune system and develop any signs of infection, such as a temperature or symptoms of the infections listed above, you should seek medical advice urgently. It may not be Pseudomonas, but should be investigated and treated without delay.

If you have a weakened immune system, have recently been treated in a healthcare setting and develop an infection, your GP will want to find out what is causing it, including whether Pseudomonas is present. If you are being treated for cancer, have cystic fibrosis or have had a transplant, follow the specific advice you have been given about whom to contact if you develop a fever. If you are very unwell, call NHS 111, or 999 in an emergency.

nidirect says that in Northern Ireland steps are taken to control and minimise the spread of Pseudomonas by screening for the bacterium on the parts of the body where it can be found, usually by taking swabs from areas such as the nose or throat secretions, armpit, groin and sometimes the navel. Screening policies differ between hospitals, so ask your own team what applies.

Infections caused by Pseudomonas are generally diagnosed and treated in NHS hospital care, because they occur mainly in people who are already unwell or have lines, catheters or breathing equipment. Private hospitals use the same laboratory testing and antibiotics. UKHSA also collects surveillance data on P. aeruginosa bloodstream infections in England.