Wound infections in burn victimsPractice Question #5After a horrible fire ravaged a bloc of flats, several residents were brought to the hospital for mild to severeburn treatments (see Table 1).Table 1: Patients admitted at the hospital following the fire.NameAge (years)Medical conditionSandra63Second-degree burns on 40% of her bodyMarco19Deep third-degree burns on 90% of his legsAlexandre29Deep third-degree burns on 35% of his legsMatthieu58Superficial burns on his arms and legsMaddie38Partial thickness burns on her left armMatthieu and Maddie, who were less severely burned, were treated with various topical anestheticointments and antibiotics, they were released from care and made full recoveries.Severely burned Sandra, Marco, and Alexandre were all moved to an isolated section of the ICU and initiallytreated through intravenous (for fluid resuscitation) and intra-arterial (for invasive blood pressuremonitoring) catheters.After being treated for shock and after their conditions were stabilized, Sandra, Marco, and Alexandre weretreated in the hydrotherapy room (warm running water) twice daily for 2-3 days. Hydrotherapy can stimulaterecovery and act as a pain relief for burn victims. However, the patients soon started exhibiting signs ofinfection with high fevers/malaise, and their wounds started emitting sweet-like odors.Dr. Moochin, the physician in charge of Sandra, Marco and Alexandre, was very worried about thesymptoms her patients were exhibiting. She suspected bacterial infections and without waiting fordiagnostic results, she immediately prescribed antibiotics for all 3 patients.During the twice daily dressing changes, wound exudates (fluid that leaks out from the lymph and bloodinto injured tissues) were collected from each patient using a sterile collection system, and bacterial culturetests were performed to confirm the presence of bacterial infection.After gram staining, microscopy examination showed that the isolates from all patients in the ICU weredominated by blue/purple coccoid cells, indicating a Staph infection. However, Marco's wounds werecolonized by both red/pink rods and blue/purple coccoid cells. The rods were identified as Pseudomonasaeruginosa, and the cocci were Staphylococcus aureus.Several tests were made on the samples collected from patients' wound. Dr Moochin was aware of thevarious other ways bacteria can transiently survive antibiotic treatments and wanted to know whichmechanism was at cause. Knowing the cause could help her treat her patient in the best possible way. To do so, she ordered the following molecules to be measured in each sample:c-di-guanylate monophosphate (c-di-GMP)Polyphosphate (poly-P)Exopolysaccharides (EPS)Autoinducers (AI)• Guanidine tetraphosphate (ppGpp)The lab came back with the following results for the following patients:Marcoc-di-GMPPoly-PEPSAl(p)ppGppControlS.aureus+++++++++P.aeruginosa++++++++++++Alexandrec-di-GMPPoly-PEPSAI(p)ppGppControlS.aureus+++++++++++P.aeruginosan/an/an/an/an/aDr Moochin is aware that P.aeruginosa possesses a TA system which promotes virulenceand help the bacterial population to resist antibiotic treatment. The P.aeruginosaToxin/Antitoxin (TA) system leads to the activation of an RNAS (a different system thenthe HipAB system seen in class). The end results are similar tough, when activated, thisP.aeruginosa TA system leads to cell dormancy.Thinking about what you know of the mechanisms that lead to cell dormancyand persistence, how could the activation of an RNAse by the P.aeruginosa TAsystem have a similar effect then that of the HipAB system? Explain yourreasoning.

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Rnase is an enzyme that is used to degrade the RNA molecules.
While HipAB is a…