Infecciones osteoarticulares por micobacterias en un hospital universitario

Drug treatments for prosthetic joint infections in the era of multidrug resistance

INTRODUCTION

Despite many advances, the management of prosthetic joint infection is still a complex issue. Moreover, in recent years the problem of antimicrobial resistance has emerged as an important challenge.

AREAS COVERED

We analysed recent advances in different aspects of prosthetic joint infections. The importance of biofilms needs to be considered for antibiotic selection because, when embedded in these structures, bacteria acquire resistant behaviour. Moreover, the presence of resistance mechanisms in some species of organisms increases the difficulty of management. In this sense, the growing importance of methicillin-resistant staphylococci, multidrug-resistant Enterobacteriaceae or Pseudomonas aeruginosa is of increasing concern. Together with these organisms, others with constitutive resistance against most antibiotics (like Enterococcus sp., mycobacteria or fungi) represent a similar problem for selection of therapy. Research into new materials that can be used as drug carriers opens a new field for management of these infections and will likely come to the front line in the coming years.

EXPERT OPINION

Individualised therapies should carefully consider the aetiology, pathogenesis and antimicrobial susceptibility. Satisfactory clinical outcome could be further fostered by enhancing the multidisciplinary approach, with better collaboration in the antibiotic selection and the surgical management.

[The Mycobacterias of Rapid Growth and the hospital infection: a public health problem]

This study is a literature review with the objective to reflect concerning the infections caused for Mycobacteria of Rapid Growth, a problem of public health that emerges in the context of the Brazilian hospitals. These mycobacteria are ambient, but patogenic, being possible to infect medical supplies and cause infections in surgical wound and skin illnesses. Important variables of difficult economic and financial evaluation, as decurrent physical and psychological damages of this type of infection, defy the researchers and confer relevance to the thematic one.