Presented by Rohit kr.SharmaM.SC.(MB), CIDE

Role of Microbiology in Diabetes

Microbiology: study of microbesInfection is the lodgement and multiplication of organism in the tissue of host.

Many infections are common in diabetes patients

Polymicrobial

INTRODUCTION

Adherence of bacteria

Infection increased the risk of complications in diabetes

Suppressed immunity

Infections attack all organs and systems

Hosts factors influence infection

Wound type Depth Location Immune competence of the

host

Major infections associated with diabetes

Respiratory infections Streptococcus pneumoniae and influenza virus. H1N1 infection Tuberculosis: Mycobacterium tuberculosis Patients with diabetes are at higher risk of

tuberculosis than individuals without DMSkin and soft tissue infection Persons with DM are more predisposed to skin and

soft tissue infections such as folliculitis, furunculosis, and subcutaneous abscesses.

Head and neck infectionInvasive external otitis : Infection of the

external auditory canal that can extend to the skull base and adjacent regions.It often affects elderly diabetic individuals and the etiologic agent is usually Pseudomonas aeruginosa

Rhinocerebral mucormycosis :The genus most commonly associated with human infections is theRhizopus, followed by Mucor This infection occurs in approximately 50% of the cases in individuals with DM due to the greater availability of glucose to the pathogen that causes mucormycosis, the decrease in serum inhibitory activity against the Rhizopus in lower pH, and the increased expression of some host receptors that mediate the invasion and damage to human epithelial cells byRhizopus.

GASTROINTESTINAL AND LIVER INFECTIONS

Gastritis caused by Helicobater pylori

Emphysematous cholecystitis : The main pathogens are Salmonella enteritidis and Campylobacter

Enteroviruses : Coxsackie B4 and B3 virus

Kidney infections UTI : The main risk factors for UTI in DM are: inadequate

glycemic control, duration of DM, diabetic microangiopathy, impaired leukocyte function, recurrent vaginitis, and anatomical and functional abnormalities of the urinary tract.

The organisms involved most commonly are Escherichia coli, Klebsiella pneumoniae, and Candida spp.

High urine glucose content and defective host immune factors predispose to infection.

Complicated UTIs in patients who have diabetes include renal and perirenal abscess, pyelonephritis,emphysematous cystitis, fungal infections,.

Foot infection

Foot infections are the most important chronic complications of DM, being one of the most common causes of hospitalization and often resulting in amputation, osteomyelitis, and death

These infections can be mono-microbial or poly-microbial. Staphylococcus aureus  and

Staphylococcus epidermidis are isolated from around 60% of all the infected ulcers. 

If the tissues continue to receive insufficient oxygen, tissue death (gangrene) occurs. Gangrene is a serious and potentially life-threatening condition. Other potentially serious problems that may develop include cellulitis (infection of the tissues beneath the skin) and osteomyelitis (infection of the bone);sepsis (the infection spreads to the bloodstream) also is  possible.

A Diabetic foot exhibit any pathology result from DM.

Due to neuropathy – reduced feel pain

Infection lead to overwhelming tissue estruction and amputation.

TYPES OF DIABETIC FOOT

Neuropathic foot: Result from injuries that are unperceived by patients because of loss of sensation

Neuroischaemic foot: Neuropathy+ ischaemic

diagnosis Blood Biopsy Swab Fluid Bone specimen

Prevention

Treatment

Future prospects