An endocarditis patient under a physician's care develops a urinary tract infection (UTI). A group D enterococcus (Enterococcusfaecium) is isolated but the UTI does not respond to ampicillin and gentamicin treatments. Which of the following options would be considered the most clinically appropriate action?
This question demonstrate commonly occurring clinical infectious diseases and microbiologic problems. Enterococci may be resistant to ampicillin and gentamicin. Vancomycin would be the drug of choice. However, laboratory results do not always correlate well with clinical response. The National Committee on Clinical Laboratory Standards recommends testing enterococci only for ampicillin and vancomycin. Some symptomatic patients may have 10 leukocytes per milliliter of urine but relatively few bacteria. The patient is likely infected and the organisms, particularly if in pure culture, should be further processed.
Consider vancomycin as an alternative drug
Determine if fluorescent microscopy is available for the diagnosis of actinomycosis
Do no further clinical workup
Suggest to the laboratory that low colony counts may reflect infection
Bacteria