Terrance V Corder

Section 1: Identification of the unknown pathogen

Patient is Terrance V. Haller, a 13-year-old male who enjoys outdoor activities such as skateboarding. No previous medical history and there are no known allergies. Terrance had a skateboarding accident where there were multiple lacerations and contusions. The wound on his forearm extending to his elbow was slow healing and therefore became pus producing. The patient has since returned to his primary care physician to find out what is going on.

After Terrance visited with his PCP a sample was collected and necessary test were performed to determine what pathogen or bacteria was the cause of Terrance 's infection. In order to have a better understanding of what they are working with and how to

Though there are hundreds of medications available to prescribing doctors knowing which one to give in certain situations is where the mystery begins. Testing antibiotics allows providers to learn more about the bacteria they are working with as well as the individual who would be ingesting the medicine. If any antibiotic was given and no results appeared then not only was the provider wasting their time but the patient is as well and they are more than likely still sick. By conducting antibiotic testing it confirms the susceptibility or detects resistance (Oxford, 2009). There were four different antibiotics were used to determine what would be the best option for Terrance. After lawn inoculating a Meuller Hinton plate and placing the samples of medication, the plate was then incubated for one week at 37 degrees Celsius. The first medication choice was Trimethoprim, this produced a zone of inhibition of 16mm, therefore being sensitive to the bacteria. Antibiotic number two was nalidixic acid, this too, has a zone of inhibition of 16mm but is considered intermediate. The next antibiotic was erythromycin which produced a zone of inhibition of zero and was therefore resistant. The last antibiotic that was chosen to be used in the experiment was ciprofloxacin. This antibiotic produced a zone of inhibition of 26mm and was therefore sensitive. After a little bit more research it was concluded that K. oxytoca produces B-lactamase, therefore making it resistant to penicillin and ampicillin (MicrobeWiki, 2015). Now that testing has been done the providers know what type of medication would be best to start with. Two out of four medications could possibly be used to attack the infection. If the patient were to take Ciprofloxacin the mechanism of action would be to inhibit relaxation of DNA; inhibit DNA gyrase in