ENTEROCOCCI TEAM CASE STUDY 2 Team Table 6: Emerita Arias Ofili Okolonwamu Romelene Juban Microbioloy Bio 16 Dr. Janet Fulks 12 October 2006.

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Presentation transcript:

ENTEROCOCCI TEAM CASE STUDY 2 Team Table 6: Emerita Arias Ofili Okolonwamu Romelene Juban Microbioloy Bio 16 Dr. Janet Fulks 12 October 2006

Diagnosis  Joseph Lincoln is a 62 year old coronary-by- pass patient that has been in ICU since his surgery.  This week he began to exhibit symptoms of pneumonia. A sputum specimen was sent for culture and sensitivity.  The lab reported a Gram stain with GPC and numerous WBCs.  The culture displayed organisms identified as Enterococci.  The sensitivity for the organism reveals a resistance to Vancomycin.

Pictures (1) Vancomycin- Resistant Enterococci (VRE) (2) (3)

Characteristics  GP cocci  Environmental conditions  Facultative anaerobe  Tolerate sodium azide & concentrated bile salts  Strains are homofermentative  Glucose fermentation  Inhibit in humans & other animals  Species: E. faecium & E. faecalis  Two types: Intrinsic and Acquired (4)

Meaning of the Resistance Displayed  Prophylactic practice  Opportunistic Microorganisms  Over-prescription of Vancomycin  Treatment of MRSA=VRE  VanA, VanB

Bacteria DNA Exchange  Intrinsic Resistance vs. Acquired Resistance  Conjugation

Suggested treatment for patient  Isolates bacteria  VRE treatment driven bacterial antibiotic resistance VRE resistant to gentamicin VRE high-level penicillin resistant VRE intrinsic pen G/AMP resistance VRE: Ampicillin, Vancomycin, & Aminoglycoside resistance  Current treatments by microbiology report

Patient Prognosis  Prognosis based on patient level of resistant & other factors  Recovering rate is 50/50 chance

Special Precautions  Isolated room  Universal precaution  IV ABT Therapy  Series of microbiology lab test  Therapeutic level test (Peak & Trough)

References  Picture # 1:  Picture # 2: l l  Picture # 3: l l  Picture # 4:     w3.ouhsc.edu/enterococcus/news.asp   Bauman, Robert. Microbiology Alternate Edition with Disease by Body System. Copyright 2006 by Pearson Education Inc., San Francisco, CA.   The Stanford Guide to Antimicrobial Therapy 2006 