A 79-year-old Nursing Home resident is admitted via theEmergency Department with a fever and suprapubic pain. He has along-term urinary catheter. A diagnosis of a catheter-associatedurinary tract infection was made and he was commenced onintravenous Cefuroxime and Gentamicin.
48 hours after his admission the final report on his Catheterspecimen of urine (CSU) shows the following:
Microscopy: white cell count (WCC) of >1000 (Normal<10)
Culture: >105 CFU/ml of E. coli,
o Resistant to amoxicillin, nitrofurantoin, ciprofloxacin,co-amoxiclav o Susceptible to cefuroxime, gentamicin,piperacillin-tazobactam.
As a result, the gentamicin is stopped and the cefuroxime iscontinued for 7 days.
On the 7th day of his admission he develop diarrhoea – fourepisodes of Type 6 stool over a 24-hour period. He has no nausea orvomiting although he is complaining of crampy abdominal pain. Noother patients or staff on the ward have similar symptoms.
What is the likely cause of these symptoms?
Describe the follow up care plan
