Imaging pulmonary infectious diseases in immunocompromised patients

A structured diagnostic algorithm for patients with ARDS

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2023. Other selected articles can be found online at  https://www.biomedcentral.com/collections/annualupdate2023 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from  https://link.springer.com/bookseries/8901 .

Diabetes-associated infections: development of antimicrobial resistance and possible treatment strategies

Diabetes mellitus is associated with various types of infections notably skin, mucous membrane, soft tissue, urinary tract, respiratory tract and surgical and/or hospital-associated infections. The reason behind this frequent association with infections is an immunocompromised state of diabetic patient because uncontrolled hyperglycemia impairs overall immunity of diabetic patient via involvement of various mechanistic pathways that lead to the diabetic patient as immunocompromised. There are specific microbes that are associated with each type of infection and their presence indicates specific type of infections. For instance, E. coli and Klebsiella are the most common causative pathogens responsible for the development of urinary tract infections. Diabetic-foot infections commonly occur in diabetic patients. In this article, we have mainly focused on the association of diabetes mellitus with various types of bacterial infections and the pattern of resistance against antimicrobial agents that are frequently used for the treatment of diabetes-associated infections. Moreover, we have also summarized the possible treatment strategies against diabetes-associated infections.

Evaluation of antifungal effect of iron‐oxide nanoparticles against different Candida species

Iron‐oxide nanoparticles (IONPs) have been widely favoured due to their biodegradable, low cytotoxic effects and having reactive surface which can be altered with biocompatible coatings. Considering various medical applications of IONPs, the authors were encouraged to study whether IONPs could be effective against fungal infections caused by Candida species. In this study, IONPs were characterised by scanning electron microscopy, X‐ray diffraction, Fourier transform infrared spectroscopy and vibrating sample magnetometer. The goal of this study was to evaluate the antifungal activity of IONPs against different Candida spp. compared with fluconazole (FLC). IONPs were spherical with the size of 30–40 nm. The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) values of IONPs ranged from 62.5 to 500 µg/ml and 500 to 1000 μg/ml, respectively. The MIC and MFC of FLC were in range of 16–128 μg/ml and 64–512 μg/ml, respectively. The growth inhibition value indicated that Candida tropicalis , Candida albicans and Candida glabrata spp. were most susceptible to IONPs. The finding showed that the IONPs possessed antifungal potential against pathogenic Candida spp. and could inhibit the growth of all the tested Candida spp. Further studies, both in vitro and in vivo (including susceptibility, toxicity, Probability of kill (PK) and efficacy studies) are needed to determine whether IONPs are suitable for medicinal purposes.

Nanotechnological applications for the control of pulmonary infections

Pulmonary infections are the major global problem. According to the global burden of disease study, lower respiratory infections were ranked third among the leading causes of death after ischaemic heart disease and cerebrovascular disease. Despite the availability of treatment options and diagnostic methods, the severity of pulmonary infections is increasing due to the emergence of multiple drug resistance and lack of sensitivity in pathogenic microbes.

In this context, nanotechnology based treatment therapies have emerged as a promising approach to circumvent the limitations of conventional therapies and also manage the problem of drug resistance in pulmonary infections. The present chapter is focused on the global status of existing management strategies of pulmonary infections and their limitations. Moreover, the role of nanotechnology for the management of pulmonary infections with a special reference to different type of nanomaterials has also been discussed.