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Microbiology Fundamentals 2nd Edition by Jennifer Bunn,Marjorie Kelly Cowan
Edition 2ISBN: 978-1259572760Microbiology Fundamentals 2nd Edition by Jennifer Bunn,Marjorie Kelly Cowan
Edition 2ISBN: 978-1259572760 Exercise 1
C A S E F I LE
Extreme Endospores
While working as a newly graduated nurse, I was caring for an elderly female patient from a local nursing home who had been admitted for a hip replacement. The patient seemed to be recovering well until she developed redness, increased swelling, and purulent discharge at the surgical site. The wound was cultured and the patient was started on a cephalosporin antibiotic. The results from microbiological testing revealed that the infection was caused by Staphylococcus aureus, a pathogen known to be sensitive to the cephalosporin drug she was already taking.
The patient successfully completed the course of antibiotic therapy, and within a few days all signs of infection had subsided. The patient was progressing well with physiotherapy, and we were beginning to plan for discharge back to the nursing home when the patient suddenly began to experience diarrhea. At first I assumed that the diarrhea was because of an expected side effect from the antibiotic, but it soon became clear that this was something more than a general side effect. On the first day, the patient had two loose bowel movements. By the second day, the episodes of diarrhea were occurring every 2 to 3 hours. The stools were watery and foul-smelling and contained large amounts of mucus. The patient complained of mild abdominal pain and cramping, and she subsequently developed a fever. The physician was notified, and a stool specimen was collected for laboratory testing.
I was surprised when the stool culture came back showing that the patient's diarrhea was actually caused by the bacterium Clostridium difficile. The patient was placed on contact isolation and was started on intravenous metronidazole (Flagyl). With this treatment, the diarrhea gradually slowed and finally stopped. Repeat cultures, performed after the metronidazole therapy was completed, showed that the infection had been successfully cleared.
• How is C. difficile spread?
• What risk factors made this patient particularly vulnerable to infection with C. difficile ?
Extreme Endospores
While working as a newly graduated nurse, I was caring for an elderly female patient from a local nursing home who had been admitted for a hip replacement. The patient seemed to be recovering well until she developed redness, increased swelling, and purulent discharge at the surgical site. The wound was cultured and the patient was started on a cephalosporin antibiotic. The results from microbiological testing revealed that the infection was caused by Staphylococcus aureus, a pathogen known to be sensitive to the cephalosporin drug she was already taking.
The patient successfully completed the course of antibiotic therapy, and within a few days all signs of infection had subsided. The patient was progressing well with physiotherapy, and we were beginning to plan for discharge back to the nursing home when the patient suddenly began to experience diarrhea. At first I assumed that the diarrhea was because of an expected side effect from the antibiotic, but it soon became clear that this was something more than a general side effect. On the first day, the patient had two loose bowel movements. By the second day, the episodes of diarrhea were occurring every 2 to 3 hours. The stools were watery and foul-smelling and contained large amounts of mucus. The patient complained of mild abdominal pain and cramping, and she subsequently developed a fever. The physician was notified, and a stool specimen was collected for laboratory testing.
I was surprised when the stool culture came back showing that the patient's diarrhea was actually caused by the bacterium Clostridium difficile. The patient was placed on contact isolation and was started on intravenous metronidazole (Flagyl). With this treatment, the diarrhea gradually slowed and finally stopped. Repeat cultures, performed after the metronidazole therapy was completed, showed that the infection had been successfully cleared.
• How is C. difficile spread?
• What risk factors made this patient particularly vulnerable to infection with C. difficile ?
Explanation
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The Clostridium difficile can spread fro...
Microbiology Fundamentals 2nd Edition by Jennifer Bunn,Marjorie Kelly Cowan
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