Modul Bjarne Cipro Day 5
Microbiological results
Concentration on agar & Microbial load
Next we will consider three parameters:
Die genaue Bestimmung der Bakterienspezies wird heutzutage mit komplizierten, aber sehr schnellen, massenspektrometrischen Methoden durchgeführt. Die Bestimmung ist wichtig, da sich daraus die Vorauswahl an Antibiotika ergibt, denn nicht alle Antibiotika wirken gegen alle Bakterien. Die endgültige Wahl des Medikaments erfolgt auf der Basis der Resistenzbestimmung und der Patientenangaben (z.B. Allergien).
Hierbei handelt es sich um eine grobe Angabe der bakteriellen Zellzahl auf der Agarplatte in Kategorien wie „massiv“, „reichlich“, „einige“ oder „vereinzelt“.
Bei der Keimlast handelt es sich um die genauere Bestimmung der bakteriellen Zellzahl pro Milliliter Material. Diese kann durch Zählen der Kolonien oder durch quantitative molekularbiologische Methoden bestimmt werden.
Material: sputum
Query: pathogen identification
Results of culture:
| Day | Pathogens | Concentration on agar | Microbial load (cells/ml) |
| 5 | Pseudomonas aeruginosa | substantial | 6,7 x 10^5 |
Determining resistance with the Kirby-Bauer test
Enter the measured values and mark to indicate which antibiotics Bjarne Pressler’s pathogens are sensitive/resistant to.
Tip: If the diameter of the zone of inhibition is below the breakpoint limit, the patient’s pathogens should be considered resistant to the antibiotic in question. If the diameter of the zone of inhibition is above the limit, the patient’s pathogens should be considered sensitive to the antibiotic in question.
Resistances:
| Antibiotic | Resistance threshold (mm) | Zone of inhibition (mm) | Day 5
sensitive resistant |
| Ciprofloxacin | 26 | ||
| Gentamicin | 15 | ||
| Meropenem | 24 |
Information on the antibiotics
Bacteria-killing antibiotic from the class of fluoroquinolones. It works by inhibiting a bacterial enzyme which is needed in copying the DNA during cell division. It works well against a broad spectrum of bacteria and is often applied in everyday medical practice for non-life-threatening infections. In the meantime, many resistant strains of different pathogens exist worldwide.
Bacteria-killing antibiotic from the class of aminoglycosides. It works by inhibiting protein synthesis at the bacterial ribosomes. Its effective spectrum is not as wide as that of ciprofloxacin, but it works well against Pseudomonas aeruginosa. Resistances exist worldwide in a few percent of bacteria.
Bacteria-killing antibiotic from the class of β-lactams and therefore a relative of penicillin. It works by disrupting the building of the bacterial cell wall and covers a very wide spectrum of dangerous pathogens. It is often used against Pseudomonas aeruginosa.
Patient consultation
Bjarne Pressler
“It’s all working out with the antibiotic. I don’t have any problems, not even the nausea that I’d sometimes had in the past. But I also don’t see any real improvement so far.”
Daily report- Day 5 Bjarne Pressler
