Patient G is a 50-year-old woman. She developed several intraabdominal abscesses following surgery for a kidney transplant. Treatment with IV ampicillin and gentamicin was not effective. The patient's temperature and white blood cell count both continued to be elevated. After an abdominal CT scan, the abscesses were drained and samples were sent for testing. Gram stains and blood cultures were performed at the same time, and both came back positive for gram-positive cocci. Further testing is under way to identify the organism. Treatment with vancomycin has been initiated pending the results of the further testing. A consultation with a clinical pharmacist was requested. QUESTION 1 1. A sample from the patient's positive blood culture was streaked onto a blood agar plate. A colony from this plate was worked up for identification and gave the following results: * Gram positive cocci in chains * gamma-hemolysis * catalase negative Which of the organisms listed in Exercise 21 is this patient most likely infected with? 2. QUESTION 2 3. Is treating Patient G with vancomycin likely to work? What method can be used to find out?
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Based on the given information, the patient is most likely infected with a gram-positive cocci in chains that is gamma-hemolytic and catalase negative. Looking at Exercise 21, the possible organisms that fit this description are Streptococcus agalactiae (Group B Show more…
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Patient G is a 50-year-old woman. She developed several intra-abdominal abscesses following surgery for a kidney transplant. Treatment with IV ampicillin and gentamicin was not effective. The patient's temperature and white blood cell count both continued to be elevated. After an abdominal CT scan, the abscesses were drained and samples were sent for testing. Gram stains and blood cultures were performed at the same time, and both came back positive for gram-positive cocci. Further testing is underway to identify the organism. Treatment with vancomycin has been initiated pending the results of the further testing. A consultation with a clinical pharmacist was requested. Is treating Patient G with vancomycin likely to work? What method can be used to find out?
Adi S.
75-year-old man presented to the emergency room with fever, shortness of breath, chest pain, and a severe, extremely productive cough. Sputum, urine, and blood cultures were collected. The direct Gram stain of the sputum sample revealed the following: - Many neutrophils (>25/LPF). - Rare squamous epithelial cells (<1/LPF). - Many Gram-positive lancet-shaped diplococci and cocci in short chains (>25/100X). - Few Gram-negative diplococci and few Gram-positive bacilli (<10/100X). The urine and blood cultures showed no growth after the incubation times. After overnight incubation at 36 degrees Celsius in 5-7% CO2, a blood agar plate inoculated with the sample revealed a mixture of two colony types. Rare non-hemolytic tiny, white colonies were present. A predominance of small, wet-looking, convex colonies was also seen, with a greenish medium around them.
Suman K.
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