Interplay between ESKAPE Pathogens and Immunity in Skin Infections: An Overview of the Major Determinants of Virulence and Antibiotic Resistance.
Gustavo Henrique Rodrigues Vale de MacedoGabrielle Damasceno Evangelista CostaElane Rodrigues OliveiraGlauciane Viera DamascenoJuliana Silva Pereira MendonçaLucas Dos Santos SilvaVitor Lopes ChagasJosé Manuel Noguera BazánAmanda Silva Dos Santos AliançaRita de Cássia Mendonça de MirandaAdrielle ZagmignanAndrea de Souza MonteiroLuís Cláudio Nascimento da SilvaPublished in: Pathogens (Basel, Switzerland) (2021)
The skin is the largest organ in the human body, acting as a physical and immunological barrier against pathogenic microorganisms. The cutaneous lesions constitute a gateway for microbial contamination that can lead to chronic wounds and other invasive infections. Chronic wounds are considered as serious public health problems due the related social, psychological and economic consequences. The group of bacteria known as ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter sp.) are among the most prevalent bacteria in cutaneous infections. These pathogens have a high level of incidence in hospital environments and several strains present phenotypes of multidrug resistance. In this review, we discuss some important aspects of skin immunology and the involvement of ESKAPE in wound infections. First, we introduce some fundamental aspects of skin physiology and immunology related to cutaneous infections. Following this, the major virulence factors involved in colonization and tissue damage are highlighted, as well as the most frequently detected antimicrobial resistance genes. ESKAPE pathogens express several virulence determinants that overcome the skin's physical and immunological barriers, enabling them to cause severe wound infections. The high ability these bacteria to acquire resistance is alarming, particularly in the hospital settings where immunocompromised individuals are exposed to these pathogens. Knowledge about the virulence and resistance markers of these species is important in order to develop new strategies to detect and treat their associated infections.
Keyphrases
- antimicrobial resistance
- pseudomonas aeruginosa
- staphylococcus aureus
- escherichia coli
- acinetobacter baumannii
- biofilm formation
- wound healing
- mental health
- multidrug resistant
- public health
- healthcare
- soft tissue
- cystic fibrosis
- klebsiella pneumoniae
- gram negative
- drug resistant
- endothelial cells
- oxidative stress
- intensive care unit
- microbial community
- risk factors
- transcription factor
- drug induced
- surgical site infection
- heavy metals
- acute care
- mechanical ventilation