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 + MRSA = Yellow Agar 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: