Patient 3
Name: Maisy Wong
Sex: Female
Age: 66 yrs
Complaints: Fever, chills, bladder distension, on indwelling catheter
Diagnosis: Urinary tract infection
Antibiotic treatment: Nil
Maisy Wong is on indwelling catheter. An indwelling urinary catheter is a tube that drains urine from the bladder into a bag. The tube is placed into the urethra (the part of the body that drains the bladder) and up into the bladder. Catheter-associated urinary tract infections are caused by a variety of pathogens, including Escherichia coli, Klebsiella, Proteus, enterococcus, Pseudomonas, Enterobacter, Serratia, and Candida. Many of these microorganisms are part of the patient's endogenous bowel flora, but they can also be acquired by cross-contamination from other patients or hospital personnel or by exposure to contaminated solutions or non-sterile equipment. Catheter-associated urinary tract infections are generally assumed to be benign. Such infection in otherwise healthy patients is often asymptomatic and is likely to resolve spontaneously with the removal of the catheter.
Microbiological Media Used
Blood Plate Agar (BAP)
Contains blood from a mammal (usually sheep), and respires to typical transperent nature, typically at a concentration of 5–10%. BAP are an enriched, differential media used to isolate fastidious organisms and detect hemolytic activity. β-hemolytic activity will show complete lysis of red blood cells surrounding colony, while α-hemolysis will only partially lyse hemoglobin and will appear green. γ-hemolysis is the term referring to a lack of hemolytic activity.
Cysteine Lactose Electrolyte Deficient Agar (CLED)
Is a valuable non-inhibitory growth medium used in the isolation and differentiation of urinary organisms. Being electrolyte deficient, it prevents the swarming of Proteus species. Lactose fermenters produce yellow colonies on CLED agar; non-lactose fermenters appear blue.
Most probable microorganisms:
Proteus mirabilis
Pseudomonas aeruginosa
E.coli
http://www.cdc.gov
http://www3.umdnj.edu
Posted by Xiu hui
3 comments:
hello, so far u got determine any tests to come down to this list of microorganisms?
Agnes
Alvin
How does the virulence factors of the 3 suspected organisms relate to the indwelling catheter the patient is experiencing?
Willie to Alvin:
Virulence factors of recognized importance in the pathogenesis of urinary tract infection (UTI) include adhesins (P fimbriae, certain other mannose-resistant adhesins, and type 1 fimbriae), the aerobactin system, hemolysin, K capsule, and resistance to serum killing. These are related to indwelling catheter.
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