Question

An 83-year-old woman was admitted to the hospital following a fever and hypotensive episode while at a nursing home. The patient had a clinical history of rheumatoid arthritis, hypertension, atrioventricular block, gastroesophageal reflux disease, deep vein thrombosis with pulmonary embolism, and depression. The patient also had a history of recurrent prosthetic left knee joint infections subsequent to the total knee arthroplasty 2 years earlier. Vancomycin-resistant enterococcus (VRE), Enterococcus faecium, was the predominate organism isolated from synovial fluid taken from her knee. The patient was placed on multiple antimicrobial regimens with numerous revisions. The course of her illness was complicated by pancytopenia, most likely caused by injury to the bone marrow, possibly from a drug reaction. At this admission, blood and synovial fluid cultures were collected. The patient was given antimicrobial therapy and supportive care, but her condition worsened and comfort measures only were instituted. When the patient died, an autopsy was requested by the family. The final pathologic diagnoses were: (a) nonhealing chronic wound infection (due to VRE) associated with prosthetic left knee joint and clinical history of sepsis; (b) pulmonary edema and pleural and peritoneal effusions; and (c) pulmonary vascular calcifications and cardiomegaly.

After reading the case, consider the following issues.

1. Role and significance of biofilms in infectious diseases
2. Consequences of untreated biofilm diseases
3. Whether standard laboratory practices should be altered in meeting the challenge presented by biofilm-associated infections

Answer 1

Q. No. a) answer :

Role and significance of biofilms in infectious diseases :

* microorganisms are attracted to the surfaces and forms a bioflims.

* these are responsible for number of diseases of persons.

* biofilms are keep the infectious organisms live on biofilm, and to find out treat ment for the exact organisms.

* we can keep alive organisms with out causing diseases.

* It provides increased protection of bacteria from anti biotics and host defenses.

Q. No. b) answer :

* complications or consequences of untreated biofilms are development of cystic fibrosis,

* mostly the implanted devices infections may arises.

* from pneumococal bioflim causes pneumonia, bacteremia and meningitis etc.

* here patient is having injury of bone marrow and synovial fluid investigation done.

* here patient is developed vancomycine resistance enterococcus. Due to improper treating of biofilm.

* and also develops septic arthritis,

* methicillin resistance staphylococcus aureus joint infections, occurs due to improper treatment.

Q. No. c) answer :

* No, standard laboratory practices are not altered in meeting challenges by biofilm associated infections ,because this standard laboratories will practice the good rules and regulations and policies according to the needs.