2/2007Infectious diseases and vaccination in adolescent diabetic patients

MARIA NOWAKOWSKA (Katedra i Zakład Mikrobiologii Lekarskiej Śląskiej Akademii Medycznej w Katowicach,Kierownik: Gayane Martirosian)

Summary
Type 1 diabetes mellitus in children with not-well controlled diabetes may predispose to infections. Children with diabetes often have contact with hospitals, which is a risk factor of colonization or infection. Infections are caused by – S. pyogenes, S. pneumoniae as well as Haemophilus influenzae and S. aureus. Those strains are among community alert pathogens. Infections are mostly located in upper and lower respiratory tract, in skin and soft tissues and in urinary tract. Apart from Gram-negative rods, enterococci, coagulase-negative staphylococci, and group B Streptococcus (GBS) are also often isolated from urine, especially in case of significant asymptomatic bacteriuria in children with diabetes. Subcutaneous insulin injection is a risk factor of infections caused by typical pathogens of skin and soft tissue – S. pyogenes, GBS, and S. aureus. In case of poor hygiene the use of insulin pump therapy, may be cause of infection with staphylococci which adhere to catheter –mainly S. aureus and S. epidermidis. In both cases necrotizing fasciitis may be suspected. Infection is associated with injection, penetrating trauma or wounds and is often observed in patients with diabetes. According to increasing amounts of bacteria resistant to antibiotics in environment specific prophylactics including vaccines possesses increasing value. Because of high protective value of vaccines all children with type 1 diabetes should be vaccinated with anti Haemophilus influenzae b vaccine, anti S. pneumoniae vaccine, anti influenza and anti hepatitis B vaccine, which protect from infection and its complications and decrease the number of carriers of serious pathogens.

Key words: type 1 diabetes, bacteria and infections in children, vaccinations