Download Case Study 4 - Bakersfield College

Would you like a side of Staph
with that heart attack?
Presented by:
Ruth Armstrong
Deanett Shaw
Christine Spanutius
Our Patient:
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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:
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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:
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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: