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 patient’s many complications his prognosis is not promising.

17. Long-term care: