Upload
rohit-sharma
View
22
Download
0
Embed Size (px)
Citation preview
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