How many days have passed since the bacteria entered her blood? (Assume a constant generation time of 6 hours) With this treatment the growth rate of the K. pneumoniae is slowed to a generation time of 55 hours. From the total number of bacteria in the patients blood at the time she arrived at the hospital which you calculated above in question vi) What would the total number of bacteria in her blood be after 5 days in the hospital?
How many days have passed since the bacteria entered her blood? (Assume a constant generation time of 6 hours) With this treatment the growth rate of the K. pneumoniae is slowed to a generation time of 55 hours. From the total number of bacteria in the patients blood at the time she arrived at the hospital which you calculated above in question vi) What would the total number of bacteria in her blood be after 5 days in the hospital?

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You are a health-care professional involved in the treatment of an elderly patient receiving outpati Show more You are a health-care professional involved in the treatment of an elderly patient receiving outpatient hemodialysis through a central vascular catheter. During preparation for hemodialysis treatment on a particularly hectic day you skip a step in your facilitys hand hygiene protocol and are not careful while putting on your gloves. Just a few cells of a Klebsiella pneumoniae strain are wiped from your hand onto the outside of your glove and are then deposited at the edge of the patients catheter. Just 3 of these cells are pushed further into the catheter adhere to the plastic and start dividing. The patient finishes hemodialysis treatment and goes home. The generation time of this K. pneumoniae strain growing as a biofilm on the catheter under these conditions is 6 hours. i) How many bacteria are present in the catheter after 48 hours? After 48 hrs. the patient returns for another hemodialysis treatment. During this second treatment the clump of K. pneumoniae cells in the catheter are flushed into the patients bloodstream. Some cells in the biofilm are dead but a total of 60 cells remain alive disperse in the patients bloodstream and begin dividing. Eventually the patient is rushed to the emergency room with symptoms of sepsis. At the time she is admitted to the hospital it is determined that she has 50 cells/mL of K. pneumoniae in her blood. If she has 3.9 L of blood in her body iii) How many generations have the bacteria been through from the time the cells entered her blood until she arrived at the hospital? iv) How many days have passed since the bacteria entered her blood? (Assume a constant generation time of 6 hours) With this treatment the growth rate of the K. pneumoniae is slowed to a generation time of 55 hours. From the total number of bacteria in the patients blood at the time she arrived at the hospital which you calculated above in question vi) What would the total number of bacteria in her blood be after 5 days in the hospital? (6pts) Since the infection is getting worse it is clear that the treatment with ceftriaxone is not working. Also at this time the results come back from the antibiotic resistance tests on the K. pneumoniae isolate from the patient. It has been determined that this isolate is resistant to ceftriaxone cefotaxime and ceftazidime AND is non-susceptible to the carbapenem antibiotic doripenem. Thus it meets the CDCs criteria for classification as a KPC strain (Klebsiella pneumoniae carbapenemase) (see CDC Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE) 2015 CRE Toolkit; http://www.cdc.gov/hai/organisms/cre/cre-toolkit/). This is extremely serious. The patient must be kept in isolation and the infection route is traced to the catheter. KPC has a 50% mortality rate and there is little hope for the patients survival. An emergency decision is made to treat the patient with the combination of amikacin (an aminoglycoside antibiotic) and ciprofloxacin. x) How many days of uninterrupted amikacin and ciprofloxacin treatment would it take for the infection to clear? (6pts) (Assume that growth is completely arrested. ) (Multiple choice) Choices: at least 7 days; at least 14 days; at least 21 days; at least 28 days; at least 35 days; at least 6 months Show less
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