Does my pt really have sepsis?

[lainith]

Admitting Dx "Sepsis of unknown origins". Initial blood cultures drawn on 1/30/09 showed no growth. Does she really have sepsis?

Also, her wound cultures were positive for staph aureus and pyogenes. Stupid question maybe but is it only "MRSA" once they decide it's Methicillin resistant?

Thanks!

[hypocaffeinemia, BSN, RN]

Admitting Dx "Sepsis of unknown origins". Initial blood cultures drawn on 1/30/09 showed no growth. Does she really have sepsis?

Look at the patient: is she exhibiting signs and symptoms of sepsis that would lead a practitioner to such a diagnosis? Was she at the time of admission?

Here's an overview: http://emedicine.medscape.com/article/972559-overview

Note that even viral infections can mimic or instigate a systemic inflammatory response, and they won't show up on a blood culture.

Also, her wound cultures were positive for staph aureus and pyogenes. Stupid question maybe but is it only "MRSA" once they decide it's Methicillin resistant?

Thanks!

The determination that it is resistant is performed via a sensitivity test. They test the culture's response to different antibiotics in order to provide detailed information to the practitioner regarding which antibiotics the strain is resistant and susceptible to. It is via this testing that S. aureus can be found to be MRSA.

Also, PCR testing can quickly identify known strains of MRSA (most commonly via nasal swab screens).

[Daytonite, BSN, RN]

What does the doctor say in his progress notes? The doctor and pathologist will make the determination that the patient has MRSA.