4.5 Article

Bacterial strains colonizing the sensor electrodes of a continuous glucose monitoring system in children with diabetes

Journal

ACTA DIABETOLOGICA
Volume 58, Issue 2, Pages 191-195

Publisher

SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s00592-020-01601-w

Keywords

Diabetes type 1; Skin complications; Skin infections; CGM; Continuous glucose monitoring system; Sensor colonization

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The study aimed to identify bacterial strains on CGM sensor electrodes through microbiological tests. It was found that older children were more likely to have their sensor electrodes colonized by bacterial strains.
Introduction The higher frequency of infections in diabetic patients is caused by a hyperglycemic environment, which promotes immune dysfunction. People with diabetes are more prone to skin infections. A continuous glucose monitoring (CGM) system provides information on changes in blood glucose (BG) levels throughout the day. Its use facilitates optimal therapeutic decisions for a diabetic patient. One of the factors limiting the use of CGM is inflammation at the insertion site. Aim of the study The aim of the study was the microbiological identification of the bacterial strains which are found on CGM sensor electrodes. Material and methods We performed microbiological tests on patients ' CGM Enlite Medtronic electrodes, which were removed after 6 days of usage according to the manufacturer ' s instructions. 31 sensors were examined from 31 children (14 girls) aged from 0.5 to 14.6 years. The microbiological analysis was routinely performed at the Department of Children's Diabetology Medical University of Silesia in Katowice, Poland. Results 12 (39%) of the electrodes were colonized. In 11 (92%) cases the electrodes were colonized by one bacteria strain. 7 times methicillin-sensitive coagulase negative staphylococcus (MSCNS) was detected. We also found one case ofKlebsiella pneumoniae, Ochrobactrum tritici, Bacillus sonorensisand methicillin-resistant coagulase-negative Staphylococci (MRCNS) colonization. One electrode was colonized by the mixed floraEnterococcus faecalis, methicillin-susceptible coagulase-negative Staphylococci (MSCNS),Pseudomonas stutzeri, methicillin-susceptibleStaphylococcus aureus(MSSA). The median HbA1c in the group with colonization of electrodes was 6, 85% (6, 3-7, 6%) versus 6, 3% (5, 8-7, 5%) in the group without colonization. The median BMI in the group with colonization of the electrodes was 17.10 kg/m(2)(16.28-18.62 kg/m(2)) versus 15.98 kg/m(2)(15.14-17.96 kg/m(2)) in the group without colonization. Statistically, significantly more frequently electrodes are colonized in older children (median age in the group with colonization of electrodes 11.43 years (6.52-12.27 years), without colonization 8.42 years. (3.098-9.375 years); (p = 0.033). Conclusions It seems that older children are more likely to have their sensor electrode colonized by bacterial strains.

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