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Case study of streptococcus pneumoniae
Clinical case study streptococcus pneumoniae
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In accordance with the World Health Organization, pneumonia still remains one of the main killers of children under the age of five, taking more than 1.1 million lives of boys and girls annually (WHO Pneumonia factsheet, 2013). Pneumonia is more prevalent in South Asia and sub-Saharan Africa. It is well known that pneumonia is a disease of respiratory system that affects the alveoli, which are the constituent part of the lungs. Normally alveoli fill with air during the breath of a healthy person, while the one with pneumonia has alveoli, which are filled with fluid and pus; hence the breathing process is painful and limits the oxygen consumption by organism. Pneumonia can be caused by several infectious agents, such as bacteria, fungi and viruses. The most common are Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), Pneumocystis jiroveci. However, significant proportion of all pneumonia is caused by Streptococcus pneumoniae. In fact, the diseases caused by S. pneumoniae also include sinusitis, meningitis, otitis and some other problems, including septic arthritis, endocarditis and spontaneous bacterial peritonitis (WHO Pneumonia factsheet, 2013). The main aim of this paper is to familiarize the reader with Streptococcus pneumoniae and one particular disease that it causes - pneumonia.
Taxonomy, morphology, physiology, virulence factors of Streptococcus pneumoniae
Streptococcus pneumoniae is a bacterium, which has the following lineage: Firmicutes; Bacilli; Lactobacillales; Streptococcaceae; Streptococcus; Streptococcus pneumoniae (NCBI database taxonomy, 2001).
Streptococcus pneumoniae is a facultative anaerobe, which after performing a Gram-staining appears as blue-black cocci with the lancet shape, mostly in pair...
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2012. Retrieved from http://ezproxy.library.nu.edu.kz:2686/article/10.1007%2Fs11908-012-0260-x/fulltext.html
Peters-Golden, M. Pneumonia (Chapter 15). 2010. Breathing in America:Diseases, Progress, and Hope: p.155. Retrieved from http://www.thoracic.org/education/breathing-in-america/resources/chapter-15-pneumonia.pdf
Pneumonia factsheet. 2013. World Health Organization. Retrieved from http://www.who.int/mediacentre/factsheets/fs331/en/
Poll, T., Opal, M.S. Pathogenesis, treatment, and prevention of pneumococcal pneumonia. 2009. Lancet 374: p. 1543–56. Retrieved from http://www.umcutrecht.nl/NR/rdonlyres/A34BBBAE-1C56-42C1-B308-070A781CE82C/20643/2Review_pneumocpneumonia_poll_opal_lancet.pdf
Streptococcus pneumoniae TIGR4. 2001. NCBI database taxonomy. Retrieved from http://www.ncbi.nlm.nih.gov/Taxonomy/Browser/wwwtax.cgi?id=170187
Hospital-acquired infections (HAI) are preventable and pose a threat to hospitals and patients; increasing the cost, nominally and physically, for both. Pneumonia makes up approximately 15% of all HAI and is the leading cause of nosocomial deaths. Pneumonia is most frequently caused by bacterial microorganisms reaching the lungs by way of aspiration, inhalation or the hematogenous spread of a primary infection. There are two categories of Hospital-Acquired Pneumonia (HAP); Health-Care Associated Pneumonia (HCAP) and Ventilator-associated pneumonia (VAP).
The purpose of this study is to identify an unknown bacterium from a mixed culture, by conducting different biochemical tests. Bacteria are an integral part of our ecosystem. They can be found anywhere and identifying them becomes crucial to understanding their characteristics and their effects on other living things, especially humans. Biochemical testing helps us identify the microorganism present with great accuracy. The tests used in this experiment are rudimentary but are fundamental starting points for tests used in medical labs and helps students attain a better understanding of how tests are conducted in a real lab setting. The first step in this process is to use gram-staining technique to narrow down the unknown bacteria into one of the two big domains; gram-negative and gram-positive. Once the gram type is identified, biochemical tests are conducted to narrow down the specific bacterial species. These biochemical tests are process of elimination that relies on the bacteria’s ability to breakdown certain kinds of food sources, their respiratory abilities and other biochemical conditions found in nature.
Whooping cough is a highly contagious and acute respiratory disease caused by an aerobic Gram negative encapsulated coco-bacillus bacterium, Bordetella pertussis. It is a strict human pathogen with no known animal or environmental reservoirs and an air-borne disease. On inhalation, Bordetella pertussis colonizes the ciliated cells of the bronchio-epithelium to cause disease characterised by; epithelial damage, hyper mucus secretion, pulmonary edema and paroxysmal coughing. It is often accompanied by pneumonia, otitis edema, seizures, post-tussive vomiting and encephalopathy (1).
Ventilator-associated pneumonia (VAP) remains to be a common and potentially serious complication of ventilator care often confronted within an intensive care unit (ICU). Ventilated and intubated patients present ICU physicians, nurses, and respiratory therapists with the unique challenge to integrate evidence-informed practices surrounding the delivery of high quality care that will decrease its occurrence and frequency. Mechanical intubation negates effective cough reflexes and hampers mucociliary clearance of secretions, which cause leakage and microaspiration of virulent bacteria into the lungs. VAP is the most frequent cause of nosocomial infections and occurs within 48 hours of intubation. VAP is a major health care burden with its increased morbidity, mortality, longer ventilator days and hospital stay, and escalating health care cost.
Bacteria play a large role in our health, the environment, and most aspects of life. They can be used in beneficial ways, such as decomposing wastes, enhancing fertilizer for crops, and breaking down of substances that our bodies cannot. However, many bacteria can also be very harmful by causing disease. Understanding how to identify bacteria has numerous applications and is incredibly important for anyone planning to enter the medical field or begin a career in research. Having the background knowledge of identifying an unknown bacteria may one day aid healthcare professionals diagnose their patient with a particular bacterial infection or help researchers determine various clinical, agricultural, and numerous other uses for bacteria.
My disease is Streptococcal pneumonia or pneumonia is caused by the pathogen Streptococcus pneumoniae. Streptococcus pneumoniae is present in human’s normal flora, which normally doesn’t cause any problems or diseases. Sometimes though when the numbers get too low it can cause diseases or upper respiratory tract problems or infections (Todar, 2008-2012). Pneumonia caused by this pathogen has four stages. The first one is where the lungs fill with fluid. The second stage causes neutrophils and red blood cells to come to the area which are attracted by the pathogen. The third stage has the neutrophils stuffed into the alveoli in the lungs causing little bacteria to be left over. The fourth stage of this disease the remaining residue in the lungs are take out by the macrophages. Aside from these steps pneumonia follows, if the disease should persist further, it can get into the blood causing a systemic reaction resulting in the whole body being affected (Ballough). Some signs and symptoms of this disease are, “fever, malaise, cough, pleuritic chest pain, purulent or blood-tinged sputum” (Henry, 2013). Streptococcal pneumonia is spread through person-to-person contact through aerosol droplets affecting the respiratory tract causing it to get into the human body (Henry, 2013).
Craven , D., & Hjalmarson, K. (2010). Ventilator-associated tracheobronchitis and pneumonia: thinking outside the box. Clinical Infectious Diseases: An Official Publication Of The Infectious Diseases Society Of America , 1, p.S59-66. Retrieved from http://ehis.ebscohost.com/eds/detail?sid=44b983f2-9b91-407c-a053-fd8507d9a657@sessionmgr4002&vid=9&hid=116&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ==
Haas, D. F. (1990). The Chronic Bronchitis And EMPHYSEMA. New York,NY: John Wiley and Sons, Inc.
The Cumulative Index to Nursing and Allied Health Literature (CINAHL) was used to find peer-reviewed articles, using query terms such as: aspiration pneumonia, ventilator, and prevention. In addition, the TWUniversal search engine was utilized to find peer-reviewed articles, with the key words: aspiration pneumonia, ventilator, and enteral.
Tettelin, H., Nelson, K. E., Paulsen, I. T., Eisen, J. A., Read, T. D., Peterson, S., et al. (2001). Complete genome sequence of a virulent isolate of Streptococcus pneumoniae. Science. Retrieved from http://www.sciencemag.org/content/293/5529/498.short (Accessed December 12, 2013).
S. pyogenes is a bacterium that permeates our society. Today it is commonly known as the cause of “Strep. throat,” or Streptococcal pharyngitis. Modern medicine has caused the eradication of most of its advanced infections, while this most common form of infection still thrives. It is very contagious, and pyogenes travels quickly through places where bacteria flourish, such as schools and health institutions. The body cannot fight this bacterium very well without help, and S. pyogenes was a common cause of death until the introduction of antibiotics in the twentieth century. It has a number of ways to subdue the immune system, but it is almost completely vulnerable to penicillin, even after decades of exposure. While generally no more than a nuisance, this bacterium continues to be an interesting topic of discussion. (6,3,2)
Person, A. & Mintz, M., (2006), Anatomy and Physiology of the Respiratory Tract, Disorders of the Respiratory Tract, pp. 11-17, New Jersey: Human Press Inc.
Parker, Steve. "Chronic Pulmonary Diseases." The Human Body Book. New ed. New York: DK Pub., 2007.
Chronic bronchitis is a disorder that causes inflammation to the airway, mainly the bronchial tubules. It produces a chronic cough that lasts three consecutive months for more than two successive years (Vijayan,2013). Chronic Bronchitis is a member of the COPD family and is prominently seen in cigarette smokers. Other factors such as air pollutants, Asbestos, and working in coal mines contributes to inflammation. Once the irritant comes in contact with the mucosa of the bronchi it alters the composition causing hyperplasia of the glands and producing excessive sputum (Viayan,2013). Goblet cells also enlarge to contribute to the excessive secretion of sputum. This effects the cilia that carry out the mechanism of trapping foreign bodies to allow it to be expelled in the sputum, which are now damaged by the irritant making it impossible for the person to clear their airway. Since the mechanism of airway clearance is ineffective, the secretion builds up a thickened wall of the bronchioles causing constriction and increasing the work of breathing. The excessive build up of mucous could set up pneumonia. The alveoli are also damaged enabling the macrophages to eliminate bacteria putting the patient at risk for acquiring an infection.
Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...