45 yrs old Ramlal has intra-abdominal sepsis. The causative organism was found to be vancomycin, gentamycin and ampicillin resistant. It grows well in presence of 6.5% NaCI and arginine. Bile esculin hydrolysis is positive. Which of the following is the organism? –
## Core Concept
The question tests the identification of a specific bacterial species based on its resistance pattern and biochemical characteristics. The organism in question exhibits resistance to vancomycin, gentamicin, and ampicillin, and has specific growth requirements and biochemical test results.
## Why the Correct Answer is Right
The organism grows well in the presence of 6.5% NaCl and arginine, and bile esculin hydrolysis is positive. These characteristics are key to identifying *Enterococcus* species, which are known for their ability to grow in high salt concentrations and their positive bile esculin test. The resistance pattern to vancomycin, gentamicin, and ampicillin is also consistent with *Enterococcus faecium*, a species that is often resistant to multiple antibiotics.
## Why Each Wrong Option is Incorrect
* **Option A:** This option is incorrect because the characteristics provided do not match those of the organism described.
* **Option B:** This option is incorrect as it does not align with the described resistance pattern and biochemical characteristics.
* **Option C:** This option, *Staphylococcus aureus*, is incorrect because while *S. aureus* can grow in high salt concentrations, the bile esculin hydrolysis and the specific resistance pattern do not match.
* **Option D:** This option is incorrect as it does not fit the provided description.
## Clinical Pearl / High-Yield Fact
A key point to remember is that *Enterococcus faecium* and *Enterococcus faecalis* are often resistant to multiple antibiotics, including vancomycin, making infections caused by these organisms challenging to treat. The ability to grow in 6.5% NaCl and a positive bile esculin test are useful in identifying *Enterococcus* species.
## Correct Answer: E. *Enterococcus faecium*.