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Would you like a side of Staph with that heart attack? Presented by: Ruth Armstrong Deanett Shaw Christine Spanutius Our Patient: • • • • • • • • • middle-aged man heart attack hypertension non-insulin-dependent diabetes mellitus (NIDDM) high cholesterol triple bypass septic shock fever pneumonia. The Invader: • Gram-positive cocci in clusters • isolated from both lungs • surgical incision • yellowish, b-hemolytic colonies on sheep blood agar • resistant to oxacillin, penicillin, erythromycin, and gentamycin • sensitive to vancomycin Questions we would ask: • • • • • • • Is he taking any medications? Does he have any other symptoms? Does he have any other medical conditions? Does he have a family history of heart disease? When did he last see his doctor? How long has he been a diabetic? Does he follow the guidelines (diet etc) for a diabetic? The Suspects: • • • • • Methicyclin Resistant Staphylococcus aureus Micrococcus luteus Staphylococcus epidermidis Staphylococcus intermedius Streptococcus pyogenes Characteristics of MRSA: Gram-positive cocci in clusters Characteristics of MRSA: Sheep blood Agar + MRSA = Yellow Pigment Characteristics of MRSA: catalase positive Characteristics of MRSA: b-hemolytic Characteristics of MRSA: coagulase positive Mode of Transmission: Portal of Entry: Portal of Entry: Treatment: • Vancomycin • Wound debridement • CBC • Dressing changes Preventing re-infection: • Isolation • Proper protective gear (face mask, gloves) • Hand washing • Proper disposal of contaminated dressings • Proper handling of linens Prognosis: Because of our patient’s many complications his prognosis is not promising. Long-term care: