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Difficulty: EasyInfectious Diseases

Match each patient's clinical and microbiological presentation with the most appropriate targeted antimicrobial therapy.

  • An elderly patient with meningitis whose cerebrospinal fluid culture yields motile, Gram-positive bacilli.Intravenous ampicillin
  • A hospitalized patient with pyelonephritis whose urine culture grows Escherichia coli resistant to third-generation cephalosporins.Intravenous meropenem
  • A severely neutropenic patient with a cavitary lung lesion, hemoptysis, and positive serum galactomannan assay.Intravenous voriconazole
  • A hemodialysis patient with a catheter-site infection and blood cultures growing Gram-positive cocci in clusters resistant to oxacillin.Intravenous vancomycin

Answer

Listeria monocytogenes pairs with ampicillin; ESBL-producing E. coli pairs with meropenem; invasive aspergillosis pairs with voriconazole; and MRSA pairs with vancomycin.
Each pathogen has a distinct, well-established first-line treatment. Ampicillin is uniquely active against Listeria. Carbapenems (meropenem) are stable against extended-spectrum beta-lactamases produced by resistant Gram-negative rods. Voriconazole is the antifungal of choice for invasive Aspergillus. Vancomycin provides reliable coverage for oxacillin-resistant staphylococci (MRSA).

Step-by-Step Solution

1
Identify the underlying pathogen described in each clinical vignette using key microbiological and serological terms.
Pathogens identified are Listeria monocytogenes, ESBL E. coli, Aspergillus species, and MRSA.
Accurate pathogen identification is required to select narrow, targeted antimicrobial therapy.
2
Determine the first-line targeted therapy for each identified organism.
Ampicillin for Listeria, meropenem for ESBL, voriconazole for Aspergillus, and vancomycin for MRSA.
Applying standard pharmacotherapy guidelines ensures effective treatment while adhering to antimicrobial stewardship principles.

Key Concept

Targeted Antimicrobial Therapy for Classic Pathogens
Estimated Time:1m 0s
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Topics

Infectious Diseases

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