In healthcare institutions it is important to monitor the emerging resistance trends demonstrated by organisms isolated in that medical facility.Give advise to physician about best possible alternative in the following situations (explain the reasoning for your advise):

The availability of that information will help to make a forecast of the viable options for treatment if an organism’s identification is available but the susceptibility test is not ready.

Use the provided example of an Institution’s Antibiogram to provide physicians with best options for treating the isolates causing hospital acquired infection (HAI’s)

Institution’s Antibiogram showing Percentage of Sensitive Isolates

Give advise to physician about best possible alternative in the following situations (explain the reasoning for your advise):

1. A physician asks to the Microbiology MLT that for one of his patients that has a recurrent

UTI, if he should continue to prescribe Nitrofurantoin as the best alternative for this patient?

2. In the Infection Control Committee meeting, the members decided to vote to withdraw the

guideline to begin treating these infections with which antimicrobial ?

3. If an aminoglycoside is to be prescribed for a Ps. aeruginosa isolate which should be the

first choice.

4. Indicate the best choice that should be prescribed for a bacteremia caused by a coagulase

negative Staphylococcus spp.

5. For a Streptococcus pneumoniae isolated from a CSF culture indicate which would be the

best advice considering that not all antimicrobials are able to go across the blood brain

barrier.

6. If you are the Microbiology supervisor what would you do if you see that there is a

susceptibility report that indicates that a Klebsiella pneumoniae from a sputum culture from

a patient with a HAI indicates that the isolated organism is susceptible to Ampicillin.

7. A physician calls asking why the VRE isolate does not have in the report results for the

aminoglycosides type of antimicrobials, what would be your explanation.