In the hospital, the patient is started on treatment with intravenous cefoperazo

Question

In the hospital, the patient is started on treatment with intravenous cefoperazone. Cefoperazone is a third-generation cephalosporin derivative. (Cephalosporins are beta-lactam antibiotics, which are considered most effective against Gram-positive organisms, but 3rd generation cephalosporins are also effective against Gram-negative organisms. Cefoperazone is one of the few 3rd generation cephalosporins with “anti-pseudomonal” coverage, meaning it is effective against some strains of Pseudomonas.)

5) With what general bacterial process do beta-lactam antibiotics interfere?

6) With what specific activity(ies) in the process you chose in Question 5 do beta-lactam antibiotics interfere?

With this treatment, the growth rate of the P. aeruginosa is slowed to a generation time of 35 hours.
From the total number of bacteria in the patient’s blood at the time she arrived at the hospital.

7) What would the total number of bacteria in her blood be after 6 days in the hospital? (calculated value to use to aid in this = 397800)

Explanation / Answer

Ans 5: Beta-lactamase interfere with specific steps in homeostatic cell wall biosynthesis i.e., inhibit the cross-linking of the bacterial cell wall.

Ans 6: Beta lactam antibiotics kill bacteria. They block biosynthesis of peptidoglycan layer by blocking the transpeptidation step resulting in cell lysis. Beta Lactams include Penicillins, Cephalosporins, Aztreonam, Carbapenems. Modify Beta-lactams with different chemical constituents at the R positions of the structures in order to alter their properties. Spectrum of activity and pharmacology propertie changes. The mechanism of action does not change. Beta-lactams can cause hypersensitivity or the allergic reactions in some people.

The beta-lactamase inhibitors share the feature of having a beta-lactam ring with the beta-lactam antibiotics. The inhibitors possess very little intrinsic antibacterial activity. They bind to beta-lactamase and form an inactive complex which inhibits the beta-lactamase activity. They are administered in combo with a beta-lactamase antibiotic which is now effective due to the inhibition of beta-lactamase activity by the beta-lactamase inhibitors. The beta-lactam antibiotics then do their job of inactivating the PBPs and preventing bacterial growth.

Ans 7: Pseudomonas aeruginosa is a gram-negative bacilli. It is a facultative aerobes that growth with and without O2, motile and opportunistic pathogen. Grows in a wide range of temperatures and widely distributed

a. moist environments, like soil and water (hot tubs)
b. on fresh fruit and vegetables

P. aeruginosa is frequently resistant to many commonly used antibiotics. To archive synergy a combination of e.g. gentamicin and carbenicillin is frequently used. Pulmonary Infections - ventilator associated, CF, Community acquired pneumonia

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