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Streptococcus pneumoniae Streptococcus pneumoniae Patient Alma

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Streptococcus pneumoniae Streptococcus pneumoniae Patient Alma Powered By Docstoc
					Streptococcus
 pneumoniae
Patient: Alma Crost, 82 year old female.
Conditions:
 Nursing home patient
 Pneumonia symptoms
 Sputum specimen sent for culture and
  sensitivity
Lab Reports:
 GPC and WBCs
 Organism identified as Streptococcus
  pnemoniae
 Organism resistant to Penicillin,
  Ampicillin, and Amoxicillin.
                Lungs infected with
Healthy Lungs
                Streptococcus pneumoniae
   Spherical Gram Positive bacterium.
   Lancet-shaped.
   Usually seen in pairs but can occur singly
    and in short chains.
   Cells are between 0.5 and 1.25
    micrometers in diameter.
   Organisms are able to ferment glucose to
    lactic acid.
   Cell wall 6 layers thick.
   Bacterium is encapsulated
        The capsule is made of polysaccharides.
        This will not cause an immune response in systems
         that have not yet developed a humoral immunity
         such as neonates and very young children.
Streptococcus Pneumoniae
 In the 1960’s almost all strains of S.
  pneumoniae were susceptible to
  penicillin, but since then there has been
  an increasing prevalence of resistance.
      Especially in areas of high antibiotic use.
 The polysaccharide capsule makes the
  organism resistant to phagocytosis.
 If there is no pre-existing anticapsular
  antibody, alveolar macrophages cannot
  kill the pneumococci.
   Has a natural transformation system as a
    mechanism of genetic exchange.
       This process is of medical significance because
        it clearly underlies the explosion of antibiotic
        resistance in the bacterium in the past 20
        years.
   This bacteria can also be transformed with
    genes from related and unrelated bacteria.
       These conditions favor the occurrence of
        natural transformation and the emergence of
        spontaneous mutants resistant to the
        antibiotic
   Most used antibiotics for pneumonia
             Vancomycin
             Cephalothin/Cefazolin
             Ceftriaxone
             Cefpodoxime
   Vancomycin
             Patients that are older than 65 years of age are more likely to
              experience all the side effects of the antibiotic
             Most recommended treatment for this kind of bacteria.
             Less desirable between the others because of dosing and tissue
              penetration
   Cefazolin
             Works better if not taking other medications such as alcohol or
              alcohol containing medicines, minoglycoside antibiotics,
              anticoagulants, diuretics, iron supplements, among some
              others.
             Administered IV or IM
   Ceftriaxone
             Is administered IV or IM
   Cefpodoxime
          Administered orally
   Vancomycin and Ceftriaxone
          The normal side effects are nausea, dizziness, chills or
           rashes, diarrhea
          Cefpodoxime and Cefazolin don’t have these as normal side
           effects; they are rare effects of the medicines.
   All of the four antibiotics state that the presence
    of other medical problems such as bleeding
    problems, kidney disease, liver disease, poor
    nutritional status and stomach or gastrointestinal
    disease may affect the use of them.
   Our patient should be treated with Cefpodoxime
                Vancomycin is not recommended for elders
                Administration of Ceftriaxone and Cefazolin
   Other treatments include rest, adequate fluid,
    and supplemental O2
The medical history of Mrs. Crost is
unknown.
 If we assume that she is a
  completely healthy and active woman, she might
  have a chance to recover from the pneumonia
 If there are other medical conditions such as
  diabetes, heart disease, liver and/or kidney
  disease, the chances of her fully recovering are
  not likely due to the fact that she can’t be treated
  with most antibiotics.
   Patient
                 Should be isolated from the other patients
                 Precautionary measurements signs outside her door
                 Supply tissue to cover her cough as much as possible
   Health Care Provider
                 Discard protective gear before leaving the room
                 Wash hands
                 Make sure the medications are given adequately to the patient
   Public
                 The pneumococcal vaccine
                      Highly recommended for people under the age of 55
                 The flu shot is another prevention because pneumonia is a complication
                  of the flu

				
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posted:12/11/2011
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