Doenças Infecciosas Clínicas: Acesso Aberto

In recent years, the emergence and spread of bacterial and fungal superbugs have become a growing concern for public health worldwide. Superbugs, a term used to describe strains of bacteria and fungi that have developed resistance to multiple antibiotics and antifungal drugs, pose a significant threat to human health. The nature of bacterial and fungal superbugs, their causes, the challenges they present and the urgent need for a multifaceted approach to address this global crisis. Bacterial superbugs are strains of bacteria that have developed resistance to multiple antibiotics, making them difficult to treat and control. These resilient bacteria have become a significant concern in healthcare settings and communities worldwide. Understanding bacterial superbugs, their causes and the implications they have is crucial in addressing this growing public health threat.

Surgical Site Infections (SSIs) are a significant concern in healthcare settings, contributing to patient morbidity, mortality, increased hospital stay and healthcare costs. Implementing effective wound care techniques and selecting appropriate dressings can play a crucial role in reducing the incidence of SSIs. In this article, we will explore the evidence-based recommendations for wound care techniques and dressings that have shown efficacy in reducing surgical site infections. Patients with certain risk factors are more prone to developing SSIs. These include advanced age, obesity, diabetes, smoking, immunosuppression, malnutrition and the presence of pre-existing infections. Patients may be required to undergo an antiseptic shower or receive preoperative antimicrobial agents to reduce the bacterial load on the skin. Hair removal, if necessary, should be done using clippers rather than shaving, as shaving can cause micro-cuts and increase the risk of infection.

Bloodstream infection is a severe and life-threatening condition characterized by the presence of microorganisms, such as bacteria, viruses, or fungi, in the bloodstream. It is a global health concern and a leading cause of morbidity and mortality, particularly in hospital settings. Bloodstream infections can arise from various sources, including infected wounds, surgical sites, urinary tract infections, respiratory infections, or through the use of invasive medical devices like central venous catheters. Bloodstream infections can manifest with a wide range of symptoms, which can vary depending on the underlying cause and severity of the infection.

Mucormycosis, also known as zygomycosis, is a serious and potentially life-threatening fungal infection caused by a group of fungi called mucormycetes. These fungi are commonly found in the environment, such as soil, decaying organic matter and even in the nasal passages of healthy individuals. Mucormycosis primarily affects individuals with weakened immune systems, including those with uncontrolled diabetes, cancer patients, transplant recipients and individuals taking immunosuppressive medications. The infection can occur through different routes, including inhalation of fungal spores, direct inoculation into wounds or surgical sites, or ingestion of contaminated food. Once the spores enter the body, they can invade blood vessels, leading to tissue necrosis and potential dissemination to other organs. Mucormycosis can manifest in various forms, depending on the site of infection, including rhinocerebral (nose and brain), pulmonary (lungs), cutaneous (skin), gastrointestinal and disseminated mucormycosis.

Candidemia refers to a bloodstream infection caused by Candida species, a type of fungus that naturally resides in the human body. Candida is commonly found in the gastrointestinal tract, oral cavity and vaginal mucosa, where it usually exists in a harmless, balanced state with other microorganisms. However, under certain circumstances, Candida can multiply and invade the bloodstream, leading to a potentially life-threatening condition known as candidemia. Candidemia has become a significant concern in healthcare settings, particularly among immunocompromised individuals and those with underlying medical conditions. The incidence of candidemia has been on the rise in recent years, posing a challenge for healthcare providers in terms of diagnosis and treatment.

Influenza, commonly known as the flu, poses a significant public health challenge worldwide, causing substantial morbidity and mortality each year. Vaccination has long been regarded as a key strategy for preventing influenza and reducing its impact on populations. However, understanding the longitudinal impact of vaccination in mitigating influenza outbreaks requires rigorous evaluation of vaccine effectiveness over time. This article presents a comprehensive assessment of vaccine effectiveness in preventing and controlling influenza outbreaks, shedding light on the critical role of vaccination in public health efforts. However, it is essential to evaluate the effectiveness of influenza vaccines in real-world settings over an extended period to assess their long-term impact.

Antimicrobial prophylaxis refers to the administration of antibiotics or other antimicrobial agents to prevent infections in individuals at risk of
developing them. It is commonly used in various medical settings, including surgical procedures, dental work and certain medical conditions. The
primary goal of antimicrobial prophylaxis is to prevent the colonization and growth of bacteria or other microorganisms that can cause infection. In
surgical procedures, it aims to minimize the risk of Surgical Site Infections (SSIs), which can lead to complications, prolonged hospital stays and
increased healthcare costs. Antimicrobial prophylaxis involves the administration of antibiotics before surgery to prevent the growth of bacteria that
may be introduced during the procedure. The goal is to achieve adequate tissue concentrations of the antibiotic at the time of incision and during
the early postoperative period, which is when the risk of infection is highest.

Antifungal resistance is an increasingly concerning issue that threatens effective treatment of fungal infections. While much attention has been given to antibiotic resistance, the emergence of resistance in fungal pathogens has garnered significant attention in recent years. This article explores the concept of antifungal resistance, its causes, implications and the urgent need for concerted efforts to address this growing challenge. Antifungal resistance refers to the ability of fungi to withstand the effects of antifungal medications, rendering them ineffective in treating fungal infections. Fungi can develop resistance through various mechanisms, including genetic mutations, upregulation of drug efflux pumps, alteration of drug targets and the acquisition of resistance genes. This resilience can occur in different types of fungi, such as Candida, Aspergillus, Cryptococcus and other clinically significant species.

Surgical wound infections pose a significant challenge in healthcare settings, contributing to patient morbidity, prolonged hospital stays and increased healthcare costs. Among the intricate factors that contribute to the persistence and severity of these infections is the formation of biofilms. Biofilms are complex communities of microorganisms that attach to surfaces and form a protective matrix, making them highly resistant to conventional antimicrobial therapies. Understanding the complexities of biofilm formation and developing innovative strategies for their prevention and treatment are crucial in advancing the battle against surgical wound infections. The inherent resistance of biofilms makes them notoriously difficult to eliminate, leading to chronic infections and recurrent wound complications. Moreover, biofilms can develop on a variety of medical devices, such as surgical implants, catheters and wound dressings, further complicating the management of surgical wounds.

Nontuberculous mycobacteria are increasingly causing disease in humans, ranging from skin lesions to widespread disease. Its ubiquitous character in nature makes its exposure very common. For these reasons, diagnosis of the disease, the correct identification/ characterization of the Nontuberculous mycobacteria responsible for the infection, and consequently the definition of the appropriate treatment regimen, remain the major challenge. Treatment is complex, requiring the prolonged use of multiple drugs, which makes it expensive and often brings side effects for the patient. So far, it has not been possible to establish, with certainty, a relationship between in vitro assays and microbiological response to drug treatment, thus making the treatments empirical. Diagnostic and clinical criteria should be updated to enable a more reliable identification in order to improve our understanding of Nontuberculous mycobacteria epidemiology, particularly for the species that have the most potential to cause disease. As an ultimate unavoidable downstream procedure, the use of whole genome data will strongly contribute to Nontuberculous mycobacteria characterization, not only for more precise strain/species differentiation but also eventually to anticipate antibiotic resistance through the identification of resistance markers. With this review, we hope to give the viewer an overview of the Nontuberculous mycobacteria-related topics that we believe are the most important.