n 2008, 65-year-old Mr. Jones woke up complaining of abnormal fatigue and a scratchy throat. His wife took his temperature and found it to be slightly elevated. He dismissed the condition, blaming it on long days in the garden and an allergy attack. However, his symptom list grew over the next few days. He lost his appetite, his joints and muscles were sore, and he woke up wringing wet from night sweats. He continued to have a fever and his wife was worried at how pale he looked. She insisted on a doctor's visit, and after a physical and throat culture, he was sent home with instructions to take oral penicillin and Tylenol. Symptoms continued for a week, with additional complaints of headache, rapid breathing, and coughing. Heart rate was rapid, and Mr. Jones had a slight heart murmur but his throat culture was negative. As the physician begin to look for other causes, he learned from Mr. Jones that an artificial heart valve had been implanted in his heart 10 years earlier. He also learned that Mr. Jones had been treated for a skin infection with MRSA, a drug-resistant strain of S. aureus several months prior to the onset of these symptoms. These details caused immediate alarm, and Mr. Jones was rushed to the intensive care unit and placed on a mixture of IV antibiotics. By evening, he became confused and lost consciousness, and despite efforts in the operating room, Mr. Jones died during open heart surgery. Blood cultures taken before Mr. Jones died grew MRSA, and during an autopsy, the pathologist also noted small patches of S. aureus growing on the prosthetic valve. He concluded that Mr. Jones had infective endocarditis and had died when portions of the biofilm on the valve broke loose into his circulation. MRSA is either acquired in the hospital setting (HA-MRSA) or as a community-acquired infection (CA-MRSA). Locate the following journal article: Alexander J. Kallen, MD, MPH; Yi Mu, PhD; Sandra Bulens, MPH; Arthur Reingold, MD; Susan Petit, MPH; Ken Gershman, MD, MPH; Susan M. Ray, MD; Lee H. Harrison, MD; Ruth Lynfield, MD; Ghinwa Dumyati, MD; John M. Townes, MD; William Schaffner, MD; Priti R. Patel, MD, MPH; Scott K. Fridkin, MD. “Health Care–Associated Invasive MRSA Infections”, 2005–2008. JAMA. 2010; 304(6): 641–647. doi: 10.1001/jama.2010.1115 Describe changes that occurred in HA-MRSA rates from 2005 to 2008 based on this study.
In 2008, 65-year-old Mr. Jones woke up complaining of abnormal fatigue and a scratchy throat. His wife took his temperature and found it to be slightly elevated. He dismissed the condition, blaming it on long days in the garden and an allergy attack. However, his symptom list grew over the next few days. He lost his appetite, his joints and muscles were sore, and he woke up wringing wet from night sweats. He continued to have a fever and his wife was worried at how pale he looked. She insisted on a doctor's visit, and after a physical and throat culture, he was sent home with instructions to take oral penicillin and Tylenol. Symptoms continued for a week, with additional complaints of headache, rapid breathing, and coughing. Heart rate was rapid, and Mr. Jones had a slight heart murmur but his throat culture was negative. As the physician begin to look for other causes, he learned from Mr. Jones that an artificial heart valve had been implanted in his heart 10 years earlier. He also learned that Mr. Jones had been treated for a skin infection with MRSA, a drug-resistant strain of S. aureus several months prior to the onset of these symptoms. These details caused immediate alarm, and Mr. Jones was rushed to the intensive care unit and placed on a mixture of IV antibiotics. By evening, he became confused and lost consciousness, and despite efforts in the operating room, Mr. Jones died during open heart surgery. Blood cultures taken before Mr. Jones died grew MRSA, and during an autopsy, the pathologist also noted small patches of S. aureus growing on the prosthetic valve. He concluded that Mr. Jones had infective endocarditis and had died when portions of the biofilm on the valve broke loose into his circulation.
MRSA is either acquired in the hospital setting (HA-MRSA) or as a community-acquired infection (CA-MRSA). Locate the following journal article: Alexander J. Kallen, MD, MPH; Yi Mu, PhD; Sandra Bulens, MPH; Arthur Reingold, MD; Susan Petit, MPH; Ken Gershman, MD, MPH; Susan M. Ray, MD; Lee H. Harrison, MD; Ruth Lynfield, MD; Ghinwa Dumyati, MD; John M. Townes, MD; William Schaffner, MD; Priti R. Patel, MD, MPH; Scott K. Fridkin, MD. “Health Care–Associated Invasive MRSA Infections”, 2005–2008. JAMA. 2010; 304(6): 641–647. doi: 10.1001/jama.2010.1115
Describe changes that occurred in HA-MRSA rates from 2005 to 2008 based on this study.
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