Reference no: EM133349511
Assignment:
A small hospital in a rural area, St. Send Em' Home Breathing, is dealing with a suspected acute increase in nosocomial infection. In the last month four patients that had visited the same day surgery department had returned to either the ED or their primary physicians with surgical wound infections. Samples sent to the clinical lab showed a gram positive cocci growing in clusters. Biochemical tests were completed with the following results:
- Beta hemolysis on Blood agar
- Golden yellow pigment production
- Coagulase production
- Mannitol Fermentation
- Gelatin liquefaction
- Phosphatase production
- Deoxyribonuclease (DNase) production
- Tellurite reduction
The organism was identified, and a Kirby-Bauer test was performed with the following results: Oxacillin- Resistant Nafcillin- Resistant Methicillin- Resistant Penicillin- Intermediate Ampicillin- Intermediate Clindamycin- Susceptible Vancomycin- Susceptible Patients were successfully treated with intravenous vancomycin.
Questions:
1) Given the information above what is the organism?
2) What is a Kirby-Bauer test and what do the above results mean?
3) What is coagulase and what does it do?
4) Is coagulase a virulence factor?
5) What are some potential indirect sources in the same day surgery facility?
6) What about direct sources?
7) Is hand washing important in preventing the above microorganism?
8) Is it reasonable to assume that the same day surgery facility is the source of the infection? Why? Is this common in same day surgery facilities?