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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.

Temas de grande importância, como a tuberculose, são plausíveis de abordagem dentro da comunidade escolar, visto que, é uma doença com grande ocorrência e relevância. O objetivo do projeto foi promover o conhecimento da comunidade escolar acerca da importância da tuberculose, assegurando a disseminação de informações ao público-alvo. O projeto foi realizado na Escola Caminho das Estrelas, situada dentro do Centro de Lançamento do Município de Alcântara – Maranhão. A unidade de ensino contempla o ensino fundamental para 132 crianças do 1º ao 9º ano. Todos os alunos foram pré-avaliados para que fossem mensurados seus conhecimentos acerca da tuberculose. Em seguida, a temática foi explorada através de uma peça teatral com a presença dos membros executores do projeto, onde foram contemplados conceitos, sintomatologia, diagnóstico e tratamento da doença. Posteriormente, os alunos foram novamente avaliados, para assim, medir-se o aprendizado e desempenho dos alunos frente à ação proposta. Foi possível concluir através da intervenção, os escolares (1º ao 9º ano) tem pouco conhecimento sobre microbiologia, além disso, 36 (60%) das crianças do grupo 1 nunca tinham ouvido falar sobre tuberculose e 48 (80%) não sabiam sobre a cicatriz vacinal da BCG. O grupo 2, 4,33% acreditam que o tratamento da tuberculose é realizado através de chás ou de cirurgia. Por isso, se faz necessárias intervenções para que as crianças e adolescentes saibam o máximo de informações sobre a tuberculose, assegurando a disseminação de informações por elas para a comunidade em geral a sua volta.

Skin injuries constitute a gateway for pathogenic bacteria that can be either part of tissue microbiota or acquired from the environmental. These microorganisms (such as Acinetobacter baumannii, Enterococcus faecalis, Pseudomonas aeruginosa, and Staphylococcus aureus) produce virulence factors that impair tissue integrity and sustain the inflammatory phase leading for establishment of chronic wounds. The high levels of antimicrobial resistance have limited the therapeutic arsenal for combatting skin infections. Thus, the treatment of non-healing chronic wounds is a huge challenge for health services worldwide, imposing great socio-economic damage to the affected individuals. This scenario has encouraged the use of natural polymers, such as polysaccharide, in order to develop new formulations (membranes, nanoparticles, hydrogels, scaffolds) to be applied in the treatment of skin infections. In this non-exhaustive review, we discuss the applications of polysaccharide-based formulations in the healing of infected wounds in animal models and clinical trials. The formulations discussed in this review were prepared using alginate, cellulose, chitosan, and hyaluronic acid. In addition to have healing actions per se, these polysaccharide formulations can act as transdermal drug delivery systems, controlling the release of active ingredients (such as antimicrobial and healing agents). The papers show that these polysaccharides-based formulations are efficient in controlling infection and improve the healing, even in chronic infected wounds. These data should positively impact the design of new dressings to treat skin infections.