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

Presented by:Ruth ArmstrongDeanett 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: