Musuq
Forum Guru
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A 45-year-old man develops a fever 4 days after an abdominal operation. Blood cultures grow Staphylococcus aureus. Which of the following is the most likely site of infection from which the organism gained access to the blood stream?
A ) Anterior nares
B ) Sputum
C ) Stool
D ) Urine
E ) Wound
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| suv
Forum Elite
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wound
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| disha
Forum Senior
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WHY NOT ANT NARES,AS STAPH IS THE NORMAL FLORA IN THE NASOPHARYNX.
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| mousa
Forum Senior
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I AGREE WOUND......DISHA THERE IS AN OPERATION 4 DAYS AGO ,SO MOST LIKELY ORGANISM COME FROM CONTAMINATED WOUND WITH NORMAL FLORA IN THE SKIN THAT SURROUND THE WOUND AND THROUGH THAT WOUND TO BLOOD VESSEL
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| bactitech
Forum Elite
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The Staph entered through a wound infection. It did not come from the nasopharynx or from normal skin flora. If that were the case, about 15% of the population would be walking around septic all the time. Post-op wounds are common sources of Staph. aureus (AND MRSA, which they usually are, unfortunately, in hospitals nowadays. Please become very familiar with MRSA, because most of the Staph. you will treat will be this one). If you have to ask what MRSA stands for, you really need to review your micro and read the daily newspaper a bit more often.
Staph. aureus is spread by not washing your hands between patients. All you would-be surgeons: PLEASE get in the habit of washing your hands before touching any of your patients' wounds. Doctors are the most non-compliant of all hospital personnel when it comes to hand washing. Your stethoscopes and even your ties can carry this organism. Don't think that just because you're a doctor, and/or in a hurry, that you can't spread Staph. aureus (or any other bugs) from patient to patient.
I remember when I was a newbie tech in the 70's I had to draw blood from a patient that was in TB isolation. At that time we didn't have the heavy duty form fitted masks, just the tie-on kinds. I put on my mask, gloves, gown, etc., and went into the room. In comes some resident with nothing but a face mask he was holding up to his nose. Apparently the rules did not apply to him. Is this wrong? Yes!
Another time I had to wait for a doc to perform a femoral stick for me, as the patient was impossible to draw blood from. The patient was out of it, and his skin looked kind of icky in the groin area. The doc used one little alcohol swab and poked (skin cleansing was minimal). He didn't get it. Then he used the same needle and repoked about two or three more times until he finally got it, all using the same needle and not cleaning the area. I was about gagging. This is NOT good procedure.
So, please take into account that you could possibly be the perp spreading Staph. aureus around.
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Clinical Microbiology since 1974
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