Discussion
An oxidase-positive, gram-negative rod which produces a bluish-green pigment has been grown in culture from a swab obtained from an infected burn wound. This organism is susceptible to gentamicin, ticarcillin and tobramycin, but resistant to all the other antibiotics. Which of the following organisms is it likely to be?
Answer: D
Correct answer: Pseudomonas aeruginosa
Every feature points to Pseudomonas aeruginosa: it is an oxidase-positive Gram-negative rod, in contrast with the oxidase-negative Enterobacteriaceae; it produces pyocyanin and pyoverdin, giving the blue-green pigment and the characteristic sweetish odour; it is a leading cause of burn wound infection; and its resistance to most agents with sensitivity confined to the antipseudomonal aminoglycosides and penicillins is entirely typical. Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis are all oxidase negative and none produces this pigment.
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