Environmental reservoirs in healthcare settingsDownloads

The surgical equipment used during a craniectomy is sterilized using pressurized steam at 121°C for 15 minutes. Reuse of these instruments can cause transmission of which of the following pathogens?

A 50-year-old male presents to the emergency room complaining of fever, shortness of breath, and diarrhea. He returned from a spa in the Rocky Mountains five days prior. He reports that over the past two days, he developed a fever, cough, dyspnea, and multiple watery stools. His past medical history is notable for major depressive disorder and peptic ulcer disease. He takes omeprazole and paroxetine. He does not smoke and drinks alcohol on social occasions. His temperature is 102.8°F (39.3°C), blood pressure is 120/70 mmHg, pulse is 65/min, and respirations are 20/min. Physical examination reveals dry mucus membranes, delayed capillary refill, and rales at the bilateral lung bases. A basic metabolic panel is shown below: Serum: Na+: 126 mEq/L Cl-: 100 mEq/L K+: 4.1 mEq/L HCO3-: 23 mEq/L Ca2+: 10.1 mg/dL Mg2+: 2.0 mEq/L Urea nitrogen: 14 mg/dL Glucose: 90 mg/dL Creatinine: 1.1 mg/dL Which of the following is the most appropriate growth medium to culture the pathogen responsible for this patient’s condition?