Case Study Adapted from Tille 14th Edition.
A 67-year-old female with uncontrolled diabetes was recovering from a Clostridium difficile infection. The physician ordered a restart of IV fluids. At the end of a 12-hour shift, the registered nurse used the remaining contents of a partially used IV bag. In approximately half an hour the patient began to complain of chills. She was visibly shaking. The nurse gave the patient some prewarmed blankets. The chills eventually subsided. Approximately 2 hours later the patient's temperature spiked to 103F. The patient's blood pressure had plummeted to 80/62 mmHg. The patient was unresponsive. The patient was immediately transferred to the intensive care unit where she briefly regained consciousness. The patient's condition subsequently declined and experienced respiratory and kidney failure. Blood cultures were drawn. After 48 hours of incubation, the blood culture was positive and revealed gram-negative rods.
The positive blood culture was then streaked for isolation on MacConkey and 5% sheep blood agar. Following 18 hours of overnight incubation at 35°C, the organism appeared as red pigmented colonies on the sheep blood and MacConkey agars. Additional identification procedures included the following results:
KIA: K/A H2S negative
LDC and ODC: positive
ONPG: positive
IMVIC: + +
1. What condition/syndrome is consistent with the patient's symptoms? Need Assignment Help?
2. Name the bacterial membrane component that gives gram-negative bacteria a net negative charge and is implicated in the pathogenesis of this organism.
3. Name the genus and species of the most likely causative organism.
4. How did this patient most likely come into contact with this organism?