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Case Study 2:   An 85-year-old male is admitted to the emergency room of a New York City hospital suffering from breathing difficulties and coughing.  He had a high fever, cough, and chest pain. He had presented to his local physician 3 days previously complaining of fever, headache, malaise, and vague respiratory symptoms.  A year ago he moved into a long-term care facility after his wife died and he has been suffering from type two diabetes for the last thirty years.  They collected sputum for culture and sensitivity.  A gram stain indicated the presence of many white blood cells and pleomorphic gram-negative coccobacilli.  An additional urine specimen was then collected and sent to a reference laboratory to confirm the diagnosis. Case Study 2 Question 1:  What was the most likely etiologic agent of infection in this patient?

List two examples of sterile sites in the body.

Neisseria meningitidis is found in the upper respiratory tract of 5% to 15% of healthy humans. In people who have had their spleens removed, there is an increased incidence of the organism causing a potentially fatal form of meningitis. This infection in a splenectomized patient would be categorized as:

Case Study 3: Answer the following questions based upon the following clinical microbiology report: DATE: 10/25/2008  21:22:13                                          bioMerieux Vitek 2 Lab Report PATIENT NAME: HARRIET MORGAN PATIENT ID00000000 SEX: F DOB: 01/01/1931 AGE: 81Y ROUTINE CULTURE  SPECIMEN: URINE  COLONY COUNT= >100,000 CFU/ML ISOLATE: STAPHYLOCOCCUS AUREUS  SUSCEPTIBILITY TEST DRUG MIC(mcg/ml) INTERPRETATION ROUTE/DOSAGE AMPICILLIN  >=16 R PO/IV250-500MGQ6H CIPROFLOXACIN >=4 R IM/IV0.5-1.0GMQ8H ERYTHROMYCIN >=8 R PO250-500MGQ6H GENTAMICIN =8 R PO400MGQ12H PENICILLIN G >=16 R IV2.0-3.0GMQ4-6H RIFAMPIN

Beta lactamase is:

Within 5 hours of returning home from lunch at your favorite all-you-can-eat buffet restaurant you feel very sick and are vomiting. The most likely causative organism is:

Case 1: The patient was a 3 1/2 week-old male who was born at term. He required intubation at that time and continued to require respiratory support. Over a 24-hour period, the infant developed bulging anterior fontanelles (the “soft spots” in the skull), increased respiratory and heart rates, wide fluctuations in blood pressure, and difficulties maintianing adequate tissue perfusion, and his peripheral white blood cell count increased from 6,300 to 13,700/ml. The child began to have focal seizures as well. A cerebrospinal fluid (CSF) examination showed 3,900 WBC/ml (increase) with 92% neutrophils, glucose 2 mg/dl (decrease), and protein of 350 mg/dl (increase). Gram staining of the child’s CSF showed a gram-positive coccus. Case Study 1 Question 4:  Which strategy would be most successful for prevention of neonatal infections with this organism?

An antibiotic is:

Which of the following is an example of vehicle transmission of disease?

Which virulence factor is found in all Gram negative bacteria?