Seeking the Factors Predisposing to Local Skin Inflammatory State Development in Children with Type 1 Diabetes (T1DM) Treated with Continuous Subcutaneous Insulin Infusion (CSII)

Abstract

The often CSII treatment complication is local skin infection. The aim of the study was to analyze chosen factors predisposing to this complication.

Material and methods: We observed 40 children aged 1.9-15.6, suffering from diabetes for 0.1-12 and treated by CSII for 0.01-4.4 years in whom HbA1c, BMI, injection site and catheter insertion duration, catheter colonization, skin flora and Staphylococcus aureus carrier state were analyzed. The catheter cultures were prepared with Maki method. The skin and nasal vestibule swab were taken to detect local flora.

Results: In the culture of 43 catheters (Maki method) a positive growth (>10 cfu) was detected in 9 (21%), homogeny culture of coagulase-negative staphylococci in 7 and mixed culture (both S.epidermidis and S.aureus) in two cases. Skin inflammation of the injection site was observed in a total of 10 children (25%), in two of whom catheter culture was positive. A statistically significant relation between the presence of bacteria in the catheter and on the skin around the injection site was found. Among the examined parameters, the relation between the catheter colonization and HbA1c, female sex and BMI were observed.

Conclusions: Metabolic control, female sex and BMI influence the development of a skin inflammatory state in patients treated with CSII. S.aureus carrier state has no impact either on catheter colonization or the development of an infection. However, bacteria skin occurrences can predispose to catheter colonization by the strain as well as to developing an inflammation.

type 1 diabetes mellitus - continuous subcutaneous insulin infusion - CSII - skin complication - skin inflammation - catheter colonisation

References

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