A person with prolonged usage of contact lenses presented with irritation of left eye. After examination a diagnosis of keratitis was made corneal scrapings revealed growth of pseudomonas aeroginosa. The bacteria were observed to be multidrug resistant. Which of the following best explains the mechanism of antimicrobial resistance in these isolated pseudomonas aeroginosa strains
D i.e. Ability of Pseudomonas to produce biofilms Contact lens wear (paicularly soft lenses worn over night) is the most impoant risk factor for bacterial keratitis. Pseudomonas aeruginosa is responsible for > 60% of cases. Infection is more likely if there is poor lens hygiene but it can also occur even with daily disposable lenses. Bacteria may multiply in the contact lens case (box) where they are protacted from disinfection by bacterial biofilmQ. A corneal epithelium compromised by trauma & hypoxia (d/t lens) is also susceptible to infection. Antibiotic resistance to Pseudomonas Aeroginosa strains from contact lens wearer largely results from the ability of these strains to form 'slime enclosed microcolonies' or biofilms. Biofilm grown cells show increased resistance to biocides and antibiotics through multiple resistance mechanism.
Ability to transfer resistance genes from adjacent commensal flora
Improper contact lens hygiene
Frequent and injudicious use of topical antibiotics
Ability of Pseudomonas to produce biofilms