Clinical Advances in Bacteremia: From Pathophysiology to New Therapeutic Possibilities

Dear Colleagues,

Bacteremia refers to the presence of viable bacteria in the bloodstream. Bacteremia can occur in daily activities such as oral hygiene (toothbrushing) as a transient that may be spontaneously cleared, without clinical sequelae. When the host immune mechanisms cannot eliminate the bacteria from the blood, bacteremia can lead to incidence of focal infection, or the infection may progress to general bloodstream infections (BSI) and life-threatening infection or sepsis.

The pathophysiology of bacteremia is not fully understood. Cellular innate and adaptive immune responses are responsible for initial microbe clearance. The first barrier to bacterial invasion is the skin and mucosal surfaces. The solution of the continuity of the skin or mucosa plays a pivotal role pathophysiology of bacteremia. Subsequently, innate immune cells such as macrophages and neutrophils recognize microorganisms through the sensing of common microbial structures known as pathogen-associated molecular patterns (PAMPs). The most studied PAMPs are lipotechoic acid, lipopeptides, lipopolysaccharide (LPS), peptidoglycan, flagellin, and microbial nucleic acids. At the site of infection, immune cells such as neutrophils employ three major strategies to fight against microbes: phagocytosis, degranulation, and the release of neutrophil extracellular traps (NETs). In order for bacteria to cause bacteremia, they must evade the host immune mechanisms.

The first-line therapeutic intervention for bacteremia is antibiotics. Bacteremia requires urgent and appropriate antibiotics. Delay in the administration of appropriate antibiotics is associated with increased mortality. On the other hand, the long-term use and abuse of traditional antibiotics leads to the development of multiple drug resistance (MDR) bacterial strains. Today, the bacterial drug resistance is healthy problem.

With bacterial resistance becoming a serious threat worldwide, antimicrobial peptides have become a promising research area.

Dr. Theocharis G. Konstantinidis
Dr. Dimitrios Cassimos
Guest Editors

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• bloodstream infections (BSI)
• sepsis
• pathogen-associated molecular patterns (PAMPs)
• neutrophils (PMNs)
• antimicrobial peptides (AMPs)
• multiple drug resistance (MDR)