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| new_n_lost
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D Staph. Epidermidis MCC of IE in prosthetics and Cather related issues.
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| taipei817
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D 
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| lakshya_0_7
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D.....
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| jean robert
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E
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| bactitech
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As a microbiologist, the term "partial hemolysis" makes no sense. There is either beta, alpha, or gamma (no) hemolysis.
My gut reaction is that they're talking about viridans streptococci, which are alpha hemolytic, have no capsule, and are catalase negative. Subacute bacterial endocarditis (SBE) are caused by viridans streptococci (S. mutans, S. mitis amongst others).
Are they saying partial hemolysis = alpha hemolysis in your textbooks? Please clear this up for me. "REAL" micro people don't talk this way 
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| Novak75
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Hi bactitech, yes, some micro text books describe alpha hemolysis and a partial hemolysis.
E
I think that since she had symptoms only 5 days after replacement it is a good chance it might be S.aureus.
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| bactitech
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After I posted my entry last night I thought about this question for a little bit. If it's a NEW valve, you're probably talking Staph. However, it could be either S. aureus or S. epidemidis. My gut reaction is to go with D on this question.
I know we get CSF shunts that get infected with S. epi and they have to pull the shunts. Don't know if mitral valves present a different scenario. We lump S. epi into one broad category now - Coagulase negative Staphylococcus (CNS) and only attempt to speciate from positive blood cultures/CSF's - mostly to rule out Staph. lugdunensis. You will be hearing more about this one in the future - I guarantee it! It is considered an "emerging pathogen." The MIC breakpoints are different for CNS than S. lugdunensis. You only have to worry about THAT if you're in ID. 
http://en.wikipedia.org/wiki/Staphylococcus_lugdu...
http://www.cdc.gov/ncidod/eid/vol11no08/04-1177.h... - pacemaker infection
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5407a2... - see patient B
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| arlete
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Staphylococcus epidermidis is the culpitt in this case, so: D.
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| hero
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arlete wrote:
Staphylococcus epidermidis is the culpitt in this case, so: D.
Arlete, dear, do you really remember all this characteristics of bugs facing step 3?
Kind of perfectly ok to know that that is more likely staph epiderm, but catalase-coagulase-whatever... 
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| arlete
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No, I don't.
I checked on the Internet.
Cheeeeeeaaaaateeeeeerrrrr! Busted! 
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| new_n_lost
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arlete wrote:No, I don't. I checked on the Internet. Cheeeeeeaaaaateeeeeerrrrr! Busted!
Goljan has it mentioned in his notes and book.
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| arlete
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Goljan has what mentioned? 
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| new_n_lost
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arlete wrote:Goljan has what mentioned?
arlete wrote:
Staphylococcus epidermidis is the culpitt in this case, so: D.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| arlete
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Oh... I didn't use Goljan for step 1. I think I should have. But now this got funny, so I'll never forget it.
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| bactitech
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A. Catalase negative no hemolysis - probably enterococci (no hemolysis=gamma hemolysis=streptococci. Enterococcus and Group D non-enterococcus fill the bill here)
B. Catalase negative partial hemolysis (probably mean alpha hemolysis - why don't they just say this - dumb!) with positive Quellung reaction (which NOBODY uses anymore) = Streptococcus pneumoniae
C. Catalase negative partial hemolysis no capsule - probably the Streptococcus viridans group
D. Catalase positive coagulase negative - coagulase negative Staphylococci of which S. epidermidis is just one
E. Catalase positive coagulase positive - Staphylococcus aureus
Catalase is the big splitter of gram positive cocci. It is also used to ID other bugs but the big thing to remember is catalase pos --> Staphylococci. Catalase neg ---> Streptococci.
Streptococci ----> alpha, beta, and gamma hemolysis
Alpha ---> S. pneumoniae and other Strep. viridans group and other oddball Streps too numerous to go into here
Beta ---> S. pyogenes (Group A), S. aglactiae (Group B), and other beta strep Groups C,D,F,G
Gamma ---> Group D Strep (enterococci [a few of which are beta hemolytic] and non-group D [used to be called Strep bovis-equinus group. Name might be different now. We just call this Group D non-enterococci in our reports]. Enterococci are far more common in UTI's and wounds than GDNE's. VRE is Vancomycin Resistant Enterococci which are unfortunately becoming more common in many body sites and can be a serious and expensive infection to treat.
Hope this all helps.
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| GoodGirl
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So nice to see you all here ! 
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