Archive | 2021
Re-emerging Bacterial Infections of the Skin
Abstract
Re-emerging infections are diseases that were formerly major public health problems, subsequently declined but have since reappeared in a significant proportion of the population. Bacterial infections re-emerge for a variety of reasons. A combination of microbiological evolutionary mechanisms and systematic misuse of antibiotics have led to the emergence of multidrug-resistant bacteria. Four general mechanisms can cause resistance to antibiotics: inactivation or modification of the antibiotic, alteration of the target site of the antibiotic that reduces its binding capacity, modification of metabolic pathways to circumvent the antibiotic effect or reduction in intracellular antibiotic accumulation by decreasing the permeability, and increasing the efflux of the antibiotic. Moreover, environmental conditions, sociodemographic changes, and behavioral factors are also important contributors to re-emergence. The consequences are profound and include higher patient mortality rates, prolonged hospital stays, higher medical costs, and the development of resistant bacteria that can defy available antibiotic treatments. Interventions to ameliorate antibiotic resistance are centered on limiting the incidence of infections, improving antibiotic usage, developing new antibiotics, and encouraging efforts in education, surveillance, and feedback.