Early one morning a patient is admitted to a hospital for a

Early one morning, a patient is admitted to a hospital for a respiratory diease. As part of the admission procedure, a sample of urine is taken from the patient, left at the nursing station desk, and taken to the lab in the afternoon. Later, laboratory analysis shows the presence of counts of Escherichia coli of 300,000 bacteria per ml. The resident determines that urinary infection exists and orders antibiotic therapy for that infection. The respiratory infection worsens and the patient is placed in intensive care. Sputum cultures show the presence of gram positive diplococci. Antibiotic sensitivity testing shows sensitivityto ceclor and ciprofloxacin and resistance to other antibiotics. Therapy is started iwht ceclor and recovery occurs.

1. List any error that may have occured.

2. Indicate whether a urinary infection was present on admission and explain your answer.

3. Indicate what good medical practices should have been practiced in this case.

4. Name a presumptive pathogen indicated by the Gram stain results.

Solution

1.The sample of urine taken from the patient in the early morning and left at the nursing station desk until it was taken to the lab in the afternoon. Since the patient was suffering from a respiratory disease, diagnosis of the exact disease cannot be done with the help of urine test.

2. Urine infection existed as the bacterial count showed 3,00,000 bacteria per ml. This was an abnormal bacterial count which indicated bacterial infection in urine sample.

3. Lung function test should be done in order to test the proper functioning of the lungs. Sputum test also should be done in order to detect the presence of any fungal or bacterial infection in the respiratory tract. In case of bacterial infection, proper dose of antibiotics should be used as medication.

4.Presumptive pathogen indicated by the gram stain results is Staphylococcus or Clostridium sp.