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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.
Coryneform bacteria occur in different environments: soil, water, plants, organisms, humans and animals. Many of them are a part of the normal flora of human and animals while others are opportunistic bacteria. Coryneform bacteria are not new microbes, but their role in infections of humans and animals is still underestimated. The genus of Corynebacterium comprises more than 70 species, including 43 of clinical significance. Among the known Corynebacterium species are distinguished: human and animal pathogens, commensal colonizing of the skin and mucous membranes of the respiratory system and genital tract, as well as plant pathogens and saprophytes living in an abiotic environment (plant debris, soil, water). Predisposing factors for Corynebacterium spp infection include: immunosuppression, long-lasting and broad-band spectrum antibiotics, steroids, an age of over 65-years-of-age, ischemic heart disease, kidney failure, respiratory failure, diabetes, cancer, multi-organ injuries, infections by HIV and CMV viruses, prematurity, tears of the skin and mucous membranes, and invasive medical procedures. The paper presents the occurrence and virulence factors of Corynebacterium spp. Infections caused by Corynebacterium spp. Their resistance to antibiotics are also described.
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