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Group B streptococcus causes infections in woman during pregnancy and confinement, perinatal infections in newborns related to mothers carrier-state and in adults, mostly in the elderly, with one or more predisposing to infections conditions. Diabetes mellitus is the most common underlying condition. The aim of the study was to determine the frequency of GBS occurrence and GBS antibiotic susceptibility in children and adolescents with type 1 diabetes mellitus. In years 2000-2002 occurrence of GBS in some clinical materials (urine, swabs from pharynx and urogenital tract) taken from 161 diabetics: 90 girls and 71 boys, hospitalized for newly diagnosed diabetes or insufficient metabolic control/longer duration of diabetes and 37 children with hypostatura (control group) aged from 5-17 years, was examined. Susceptibility of isolated GBS strains to ampicillin, erythromycin and clindamycin was determined. GBS were obtained from different materials from 36 (22.4%) diabetic children - 25 girls (27.8%), and 11 boys (15.5%). In all examined groups GBS was detected significantly in children with insufficient metabolic control/longer duration of diabetes (27 of 36 children; p=0.029, x²=4.773). GBS in girls was isolated mainly from vestibule of vagina (25 cases) and in few cases (4) from the pharynx. GBS in boys was grown from materials from urethra (6 cases) and pharynx (5 cases). In the control group, GBS colonization was observed only in one case. All isolates (40 strains) were susceptible to penicillins, however lower susceptibility to erythromycin (3 resistant and 1 moderately sensitive) and clindamycin (3 resistant) were observed. High percentage of carriers of GBS both in girls and boys with diabetes mellitus is the potential risk factor of infection caused by GBS.
Continuous subcutaneous insulin infusion (CSII) is a commonly used, safe intensive insulin therapy method effective in maintaining normoglycaemia. The disadvantage of CSII are skin infections of the catheter injection site. The aim of the study was to gain insight on the colonization of subcutaneous insulin pump catheters by skin flora and to investigate the correlation between Staphylococcus aureus carrier state (presence in the nose), its presence on the skin and catheter. 141 catheters obtained from 94 children with T1DM and CSII were examined using the semi quantitative culture technique of Maki. The result was positive in 34 examinations (24.1%) in 30 children (31.9%). Most often coagulase negative staphylococci were isolated (30), mainly Staphylococcus epidermidis, 1/3 of the staphylococci were methicillin resistant. S. aureus was detected in 7 examinations in 6 children. S. aureus carrier state was proved in 31.9% of all examined patients, more often in children with a positive catheter culture (41.4%), there were no MRSA. No correlation between S. aureus carrier state and catheter colonization was shown. Statistically significant correlations between: coagulase negative staphylococci presence, including the methicillin resistant strains, on the skin and on the catheter surface (p<0.0001); glycosylated hemoglobin (HbA1c) and bacteria catheter colonization (p = 0.0335) were observed. Subcutaneous catheter colonization by microorganisms often occurs in CSII. Microorganisms found on the skin are the most frequent cause of the subcutaneous catheter infection.
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