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Bloodstream Infections, A Growing Challenge

The resilience of pathogens that result in bloodstream infections is discussed in an article published in a special issue of Virulence. The human fight happening at the microscopic and molecular level remains a staunch one – the human body is constantly combating pathogen attack, among which feature bloodstream infections (BSI) which are considered to be resilient. An editorial published in Virulence entitled “Bloodstream Infections: The Peak of the Iceberg” makes an exposé of how BSI need to be taken into consideration.


BSI entail viable microorganisms (like bacteria and fungi) running free in the blood of the infected patient, triggering inflammation.

The article is authored by Dr. Claudio Viscoli, a Professor of Infectious Disease from the University of Genoa. According to him, BSI constitute a great challenge for experts who manage infectious diseases. He goes further to say that the situation might go out of hand if we do not hinder the “development of resistance“.

The trend pertaining to the different forms of BSI is a dynamic one whereby resilience is increasing with time. Furthermore, we are not keeping up in this race: our antibiotics are not doing their job; rather, their efficacy is spiralling down.

BSI are categorised into 3 main types:

  1. In healthy hosts with normal functioning of the immune system
    Examples: meningitis, Salmonella-related diseases
  2. In hosts with impaired defenses because of their physiology (immature or old immune systems like those of babies and the elderly)
    Examples: pneumococcal infections
  3. In patients whose likelihood of infection is greater due of pathological or pharmacological conditions, like diabetics, or HIV-positive people
    Examples: any pathogen

Viscoli says that the epidemiology of BSI is challenging to evaluate on a worldwide-scale. While the pattern of pathogens resulting in BSI has been changing over the decades, the main causal problem remains the resistance of these microorganisms to antibiotics, thereby leading to an increased mortality rate.

Viscoli highlights the fact that bacteria have been demonstrating “extraordinary resilience capabilities” that leave the weapon of antibiotics almost useless in some cases. He, therefore, emphasises the pressing need for preventive measures, better diagnosis techniques, a more sensible use of antibiotics that have been around for a long time, together with making new molecules accessible.


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