Microbes At Bay

In everyday life we run into millions of microbes. Some of the bacteria is capable of making humans sick. The study of microbes has become very important subject to help stop potential pandemics and ensure proper hygiene. Anthony van Leeuwenhoek was the first scientist who discovered bacteria. In my study of microbiology, I got to choose an unknown bacteria to identify. It is important to start off finding the family of the unknown bacteria and then eliminating one by one the species to know which bacteria it is. By knowing the family, a scientist can save themselves a lot of time by knowing which tests need to be performed for the elimination process. This might seem like a waste of time to one but being able to correctly identify bacteria

Jack, the patient presented through Accident and Emergency to Ward D3, an acute medical ward specialising in respiratory medicine. He was admitted due to an exacerbation of dyspnoea, which was more significant over the last twenty-four hours. The writer met Jack on admission to the ward.

The nurse found Mrs Smith to be tachypnoeic, her respirations were recorded as 24 breaths per minute it was observed as being fast and it appeared that her accessory muscles were being used. Mrs Smith’s pallor also appeared flushed and her saturations were documented as 93%. The nurse used the stethoscope to check for wheeze the patient’s lungs were clear and chest rise was symmetrical. Mrs Smith was commenced on 100% oxygen through a non-rebreathe mask, oxygen as an intervention is necessary as Creed & Spiers (2010) highlight ‘metabolic demand for oxygen throughout the body is hugely increased by sepsis and is essential to ensure the supply of oxygen is maximized’ .The nurse monitored the patient closely because in her confused state the patient may try to remove the oxygen mask.

Unknown bacteria determined to be Alcaligenes faecalis because of its morphological, physiological and metabolic properties.

Ms. Sunshine immediately was placed on oxygen, sitting upright, an IV infusing, had blood work sent for numerous labs, including cardiac markers, had a chest x-ray and an electrocardiogram (EKG) performed. A clinical nurse leader is able to teach patients and patients regarding health promotion, disease prevention, or disease management (American Association of Colleges of Nursing, 2011). It is important to understand the pathophysiology behind disease processes in order to help facilitate better outcomes for Ms. Sunshine.

“Put her on 6 liters of oxygen,” I answered more confidently. As I reassessed my patient, I noticed she was breathing easier. Her oxygen saturation was now 98%. I checked her fingernail beds and lips, and the blue tinge I had noticed earlier had disappeared. I lifted her hands slightly to show the medic. He gave me a thumbs up.

On the early morning of August 17, 2002, James C., a patient in one of the wards under the supervision of Ellen Hughes Finnerty, RN, went into respiratory depression. Between 3:00 and 4:00 a.m., Ann Mugi, the patient’s primary nurse, sought the assistance of a respiratory therapist, Hiran Obeyesekere, to help her care for the patient. As Obeyesekere suctioned the patient airway, Mugi called the service of the patient’s primary care physician, Dr. Jackson, to report the changes in the patient’s respiratory status, e.g., respiratory rate of 40 breaths per minute and low urine output.

Patient “DD” is a 56-year-old woman who was admitted to a nearby hospital for respiratory failure. With the only previous medical history being chronic bronchitis, she was diagnosed upon admission with COPD, anemia, hypoxia, moderate anxiety, and dyspnea.

As the flowchart shows, a series of tests were conducted to identify the unknown bacterium #65. Microscopic observation of the gram stain indicated a gram-positive coccus bacterium. S. epidermidis was used as the gram-positive control while E. coli was used as the gram-negative control. This observation led to the elimination of all gram negative and rod-shaped genera: Enterobacter, Citrobacter, Klebsiella, Escherichia, Pseudomonas, Serratia, Alcaligenes, Neisseria, Proteus, Salmonella, Shigella, Erwinia, Veillonella, Flavobacterium, Bacillus, Arthrobacter, Lactobacillus, Listeria and Kurthia (2). By performing the catalase test, it was determined that the bacterium was catalase negative and it did not produce bubbles. M. luteus and E. faecalis were used as positive and negative controls, respectively.

Patient 2: The patient had an infection in her lungs with an unknown cause. I was on alert for drops in oxygen levels below the patient’s normal range, increases in blood pressure above the patient’s normal range, and the patient’s activity tolerance without the BiPAP machine. I was also looking for signs of a DVT.

An unknown bacterium 15 was awarded and labeled at the table ready to be identified. Using the skills and test that are taught and learned in microbiology were applied into learning what the unknown bacteria culture was. There were multiple procedures and test done in order to gain all the information needed to determine which bacteria was given. In order to find what the bacteria was the first step was finding the right environment and temperature that would allow the bacteria to thrive and grow. Determining this is one of the most important steps in being able to obtain conclusive results that would allow the results of the test to be accurate and correct. Without the correct temperature and environment the bacteria will give inconclusive results which will alter and skew the end results and may lead to the wrong conclusion. By using the methods that were obtained and learned through the microbiology class allowed the skills and knowledge to determine the bacteria and execute the tests in order to determine the culture.

“The patient is Adam Rudd, a 78 y/o white male with a history of hypertension. He has been diagnosed with hypertension past 15 years and is on anti-hypertensive medications and aspirin. He is very weak and short of breath. He is accompanied with his longtime friend Jennifer, who reports that Rudd was looking very weak and was complaining of severe headache and blurred vision before coming to the hospital. He is 5’9” and weighs 270 lb. Vital signs recorded were: oral temperature 98.20 F, BP 224/120 mm Hg with a heart rate of 102 beats/minute and respiration of 24 breaths per minute. The pulse oximetry reading was 94% on room air. He is complaining of severe headache and blurred vision. Rudd said that he did not take his antihypertensive medication or aspirin since he ran out of pills. He has not been taking his medication for past 15 days. He reports no known allergies to any medications or other substances.”

I stayed close to the patient during this whole period, but I was not paying enough attention to her low oxygen level. The patient was a healthcare aid and she kept telling me that, “It’s ok, I am always a shallow breather”. However, I should have my own judgement ability and provide more competent care with timely evaluation of the effectiveness of the interventions.

Goldberg’s article, “Microbes on the Move,” contains a personal, narrative story and few other short stories about easily spreadable viruses. In the personal story, the narrator tells about his adventure in East Africa where he contracted malaria while hiking on a mountain, but his life was saved by the park ranger and doctor. He added a note at the end of the story that one million Africans are killed by malaria each year due to lack of sufficient treatment.

I tend to be a visual learner and this video did help me out a bit to better grasp how the immune system functions. There were a couple things that were presented in this video that I wasn’t fully aware of. One of the pieces of information that I wasn’t aware of was that sweat is acidic to bacteria and contains natural antibiotics that prevent their growth. I also thought that mucus just collected foreign substances and bacteria, when in fact they also produce antibacterial enzymes that begin breaking down the bacteria as they are expelled from the body. Lastly, I thought that pus consisted just of tissue debris but it also contains living and dead white blood cells and microbes. There was another video that I watched