Page 38 - Critical Care Notes

4223_Tab01_001-044 29/08/14 10:46 AM Page 32

BASICS

Methicillin-Resistant Staphylococcus Aureus (MRSA)
Etiology
Transmitted by close contact with infected person. Health-care worker may be
colonized with MRSA strain with absence of symptoms. The Staphylococcus
aureus bacterium is resistant to methicillin, amoxicillin, penicillin, oxacillin, and
other antibiotics.
Signs and Symptoms
■ Skin infection: Boil or abscess
■ Surgical wound: Swollen, red, painful, exudate (pus)
■ Bloodstream: Fever, chills
■ Lung infection/pneumonia: Shortness of breath, fever, chills
■ Urinary tract: Cloudy urine, strong odor
■ Infective carditis
Diagnosis
■ Culture of infected area
Treatment
■ Vancomycin (Vanocin, Vancoled); trough vancomycin levels the most accu-
rate; monitoring of peak vancomycin levels not recommended
■ Linezolid (Zyvox)
■ Daptomycin (Cubicin)
Clostridium Difficile (C-diff)
2013 Guidelines for Diagnosis, Treatment, and Prevention of Clostridium diffi-
cile Infections: http://gi.org/guideline/diagnosis-and-management-of-c-difficile-
associated-diarrhea-and-colitis/
Etiology
C. difficile (C-diff) is a common cause of antibiotic-associated diarrhea (AAD)
and is transmitted through the feces or any surface, device, or material that has
become contaminated with feces.
Signs and Symptoms
■ Watery diarrhea (at least 3 BMs/day for 2 or more days), rarely bloody. May
be greenish, mucoid and foul-smelling.
■ Fever.
■ Loss of appetite.
■ Nausea.
■ Crampy abdominal pain and lower abdominal tenderness.

32