Would you like a side of Staph with that heart attack

1
Would you like a side of Staph with that heart
attack?

• Presented by
• Ruth Armstrong
• Deanett Shaw
• Christine Spanutius

2
Our Patient

• middle-aged man
• heart attack
• hypertension
• non-insulin-dependent diabetes mellitus (NIDDM)
• high cholesterol
• triple bypass
• septic shock
• fever
• pneumonia.

3
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

4
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?

5
The Suspects

• Methicyclin Resistant Staphylococcus aureus
• Micrococcus luteus
• Staphylococcus epidermidis
• Staphylococcus intermedius
• Streptococcus pyogenes

6
Characteristics of MRSA
Gram-positive cocci in clusters
7
Characteristics of MRSA

• Sheep blood MRSA Yellow
  
• Agar
  Pigment

8
Characteristics of MRSA
catalase positive
9
Characteristics of MRSA
b-hemolytic
10
Characteristics of MRSA

• coagulase positive

11
Mode of Transmission
12
Portal of Entry
13
Portal of Entry
14
Treatment

• Vancomycin
• Wound debridement
• CBC
• Dressing changes

15
Preventing re-infection

• Isolation
• Proper protective gear (face mask, gloves)
• Hand washing
• Proper disposal of contaminated dressings
• Proper handling of linens

16
Prognosis
Because of our patients many complications his
prognosis is not promising.
17
Long-term care