A 60-year-old male, a known case of COPD with hea failure was admitted with the complaints of shoness of breath and symptoms of right sided hea failure. He was catheterized and staed on treatment. After 8 days, he complained of pain in the right flank region, along with high grade fever with rigor. On examination it was observed that the urine in the catheter was cloudy and patient was also having pain in the urethral region. Urine R/M and culture studies were immediately sent. USG abdomen revealed pyelonephritis of the right kidney. Urine studies revealed increased WBCs in the urine sample. The organism was isolated, Gram staining was done. It showed tiny deep pink colonies on MacConkey agar. Colonies produced on tellurite agar are given below. The organism was heat resistant and could grow in 40% bile, 6.5% NaCl and at pH of 9.6. To which of the following drugs is the organism intrinsically resistant to: -
This is a case of enterococcus infection which causes nosocomial UTI infection. Gram stain shows gram positive coccoid bacteria which are occurring in pairs. Black colonies on tellurite agar point towards E. faecalis infection. Enterococci are intrinsically resistant to cephalosporins. The most common type of infection caused by enterococci is usually nosocomial (associated with urinary tract catheterization or instrumentation). Cystitis and pyelonephritis are common Prostatitis and perinephric abscesses may develop.
Cephalosporins
Aminoglycosides
Vancomycin
Linezolid
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