No validated susceptibility testing methods are available for the organisms discussed in this chapter. Although many of these organisms grow on the media and under the conditions recommended for testing of more commonly encountered bacteria, no standardized reference exists for antimicrobial resistance for these organisms. The lack of validated in vitro susceptibility testing methods does not allow definitive treatment and testing guidelines to be given for the organisms listed in Table 1. Although susceptibility data for some of these bacteria can be found in the literature, the lack of understanding of potential underlying resistance mechanisms prohibits the validation of the data. Review Chapter 12 for preferable strategies used to provide susceptibility information and data when vali dated testing methods do not exist for a clinically relevant bacterial isolate.

Table1. Antimicrobial Therapy and Susceptibility Testing

Because R. radiobacter and O. anthropi infections are frequently associated with implanted medical devices, therapeutic management of the patient often involves removal of the contaminated material. Although definitive antimicrobial therapies for these infections have not been established, in vitro data suggest that certain agents could be more effective than others (see Table 1). Most strains of R. radiobacter are susceptible to cephalosporins, carbapenems, tetracyclines, and gentamicin.

O. anthropi is commonly resistant to all currently available penicillins, cephalosporins, aztreonam, and amoxicillin-clavulanate but usually is susceptible to aminoglycosides, fluoroquinolones, imipenem, tetracycline, and trimethoprim-sulfamethoxazole. O. anthropi (colistin susceptible) may be differentiated from O. intermedium by colistin resistance. This resistance profile is sufficiently consistent with the species, making it potentially useful for confirming the organism’s identification. The organism may also appear susceptible to trimethoprim sulfamethoxazole and ciprofloxacin, but antimicrobial therapy without removal of the contaminated medical device may not successfully eradicate the organism.

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مواضيع ذات صلة

Laboratory Diagnosis of Rhizobium, Ochrobactrum, and Similar Organisms

Antimicrobial Susceptibility Testing and Therapy of Pseudomonas, Burkholderia, and Similar Organisms

Chlamydia trachomatis

Mycoplasma Pneumonia

Leptospira interrogans

Laboratory Diagnosis of Pseudomonas, Burkholderia, and Similar Organisms

Pathogenesis and Spectrum of Disease of Pseudomonas, Burkholderia, and Similar Organisms

Antimicrobial Susceptibility Testing and Therapy of Acinetobacter, Stenotrophomonas, and Similar Organisms

Laboratory Diagnosis of Acinetobacter, Stenotrophomonas, and Similar Organisms

Clostridium botulinum

Clostridium perfringens

Pasteurella