Specific antibiotic choices for selected pathogens

Our college enjoys throwing exotic bugs at its candidates to see what we would try to kill them with. Here is a table of bug vs. antibug, from Question 15.1  of the second paper of 2013; it has been modified to include other organisms and clinical scenarios which have been asked about. Links point to discussions, or at least to the specific question which prompted the inclusion of this organism in the list.

Numerous other questions have asked some variation on the them of "which antibiotic would be the appropriate choice for this organism?" They have included the following:

• Question 30.1 from the first paper of 2016
• Question 30.2 from the first paper of 2016
• Question 21.2 from the first paper of 2015
• Question 15.1  of the second paper of 2013
• Question 18 from the second paper of 2011
• Question 11 from the first paper of 2011
• Question 17.1 from the second paper of 2010
• Question 24.2 from the first paper of 2008
• Question 13 from the second paper of 2007

A list of organisms intrinsically resistant to imipenem:

• Stenotrophomonas maltophila
• Pseudomonas maltophilia
• Pseudomonas cepacia

• Enterococcus faecium
• MRSA

Generally speaking, carbapenem-resistant Enterobacteriacea tend to receive treatment with older (more toxic) drugs such as amikacin and colistin.

A word about Listeria monocytogenes

For whatever reason the college seem to love Listeria. Most recently, they asked the candidates to not only identify it (the suspicious Gram-positive rod in a confused woman's blood culture, from ) but also to discuss the risk factors for such an infection.

These risk factors are discussed in two reference-worthy papers: J Rocourt (1996) and Schuchat et al (1992), which talks about food-related risk factors.

• Patient factors
  • Malignancy
  • Pregnancy
  • Organ transplant recipient
  • HIV/AIDS
  • Corticosteroid therapy
  • Anything that interferes with T-cell mediated immunity
  • Extremes of age (neonates, the elderly)
• Food factors
  • ​Soft cheese
  • Food "purchased from store delicatessen counters"
  • Undercooked chicken
  • Broadly speaking, foods which are "ready to eat", stored at refrigeration temperature for prolonged periods