Image based question-65614

The organism shown in the photomicrograph below has been isolated from the CSF of a 2 year old boy suffering from meningitis.

he strain is beta lactamase producing and resistant to chloramphenicol, The most appropriate antimicrobial is ?

A. Trimethoprim — suiphamethoxazole combination.

B. Ciprofloxacin.

C. Third generation cephalosporin.

D. Vancomycin.

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Correct Answer » C Explanation

The micro-organism shown in the photomicrograph above represents H. influenzae.

• HI Inlluenzae type b produces J3 lactamases and therefore are resistant to ampicillin. These 3 lactamase producing strains remain sensitive to the extended spectrum cephalosporins

• Ceftriaxone or cefotaxime IV are used as a single agents

• Infections caused by ampicillin – resistant strains can be treated with

1. Trimethoprim – sulfamethoxazole
2. Amoxicillin I clavulanic acid
3. Extended spectrum cephalosporins
4. Azithromycin and clarithromycin

• F’loraquin lones are highly active against H. influenzae but are not currently recommended for the treatment of children or pregnailt women because of possible effects on articular cartilage