Clinical significance help

Nursing Students Student Assist

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Can someone explain the clinical significance of the following gram stain smear results to me?

0-10 Epithelial Cells/LDF

4+ WBC's

1+ Gram positive cocci

1+ Gram positive Bacilli

2+ Gram negative Bacilli

4+ Serratia marcesens

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Specializes in Complex pedi to LTC/SA & now a manager.

Moved to nursing student assistance to elicit further response. Remember clinical relevance is related to the patient presentation and assessment. There isn't enough information to respond to your query as what type of specimen was cultured? That makes a BIG difference.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

We are happy to help........what is the patients clinical presentation? It is difficult to say without having that information....what is this a result of?

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Specializes in Hospital Education Coordinator.

looks like an infection going on -S. marcesens is a fungus. It is the pink stuff that will grow in wet places, like your shower or bathtub. It can get in your lungs and cause pneumonia. Plus, anything gram positive is scary to me----

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Gram negative (E.Coli) scares me......gm- sepsis has an especially high mortality.

This site may help. Lab Tests Online: Welcome!

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Serratia is not a fungus. There are pink fungi and maybe that's what you have in your shower stall, but it's unlikely to be Serratia.

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S. marcesens is your gram neg rod (bacilli)

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Specializes in Complex pedi to LTC/SA & now a manager.

Serratia is a gram negative bacteria. Not a big wiki fan but this is a decent explanation: Serratia - Wikipedia, the free encyclopedia

S. marcesens is a cause of hospital acquired/nosocomial infections.

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Patient has a trach, obstructive sleep apnea, prader-willi syndrome, diabetes, joint disease, gastritis, etc. The culture was sputum.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Can someone explain the clinical significance of the following gram stain smear results to me?

0-10 Epithelial Cells/LDF

4+ WBC’s

1+ Gram positive cocci

1+ Gram positive Bacilli

2+ Gram negative Bacilli

4+ Serratia marcesens

Ok....like Beachy asked....what is Serratia marcensess? Is Serratia gram positive or gram negative?

Serratia species are opportunistic gram-negative bacteria classified in the tribe Klebsielleae and the large family Enterobacteriaceae. Serratia are widespread in the environment, but are not a common component of the human fecal flora
Medscape: Medscape Access medscape requires registration but it is free and a reliable credible source.

What clinical significance is an infection to this patient? What do you think?

I gave you a reference lab site that will give you the answers you seek.... Lab Tests Online: Welcome!

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Specializes in Emergency, Telemetry, Transplant.
Patient has a trach, obstructive sleep apnea, prader-willi syndrome, diabetes, joint disease, gastritis, etc. The culture was sputum.

What did they present with (i.e. SOB, abnormally high secretions, etc)? What would you expect (if anything) to 'grow out' of a sputum cx?

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