| Course | PA 514 Comprehensive Clinical Module Infectious Disease |
|---|---|
| Week | 6 |
| Paper type | Antibiogram reading exercise |
| Length | About 710 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 514 Week 6
Antibiogram Reading Exercise: A Regional Hospital's 2025 Table, a Salmonella Row Built on 19 Isolates and What It Could and Could Not Tell R.A.'s Team on Thursday Night
Student Name
Chamberlain University
PA 514: Comprehensive Clinical Module Infectious Disease
Instructor Name
Month Day, Year
Antibiogram Reading Exercise: A Regional Hospital's 2025 Table, a Salmonella Row Built on 19 Isolates and What It Could and Could Not Tell R.A.'s Team on Thursday Night
What the Table Is
The document read here is the cumulative antibiogram of the regional hospital where R.A. was admitted, covering January 1 to December 31, 2025, all inpatient and outpatient units combined, first isolate per patient per year. It was published in March 2026 by the microbiology laboratory and the antimicrobial stewardship committee. A separate intensive care unit table exists and was not used, because R.A. was admitted to a medical ward.
Table 1
Percent Susceptible, Selected Gram-Negative Rows, 2025 Cumulative Antibiogram
| Organism (isolates) | Ampicillin | Ceftriaxone | Ciprofloxacin | TMP-SMX |
|---|---|---|---|---|
| Escherichia coli (1,842) | 54 | 91 | 79 | 74 |
| Klebsiella pneumoniae (411) | R | 93 | 92 | 88 |
| Proteus mirabilis (203) | 81 | 97 | 76 | 79 |
| Salmonella species (19) | 79 | 100 | 84 | 95 |
Note. Note. R indicates intrinsic resistance. The table's footnote marks the Salmonella row as based on fewer than 30 isolates.
Reading the Row
For Salmonella, the row says that of 19 first isolates in 2025, all were susceptible to ceftriaxone, 15 to ampicillin (79%), 16 to ciprofloxacin (84%) and 18 to trimethoprim-sulfamethoxazole (95%). Read across, ceftriaxone looks like the most reliable choice for an empiric Salmonella regimen at this hospital.
The Count Beside the Row
The row rests on 19 isolates. Guidance on preparing antibiograms recommends at least 30 isolates per organism for a percentage to be reported with confidence, because small numbers make the estimate unstable (Clinical and Laboratory Standards Institute, 2022). With 19 isolates, one more resistant isolate would move ceftriaxone from 100% to 95%, and 100% of 19 does not mean resistance is absent in the community. The table's own footnote flags this, and the reading has to carry it.
Reading the Column
Down the ciprofloxacin column, susceptibility ranges from 76% to 92% across the gram-negative rows. For E. coli, 79% means about one in five isolates would not respond. That column shows why ciprofloxacin was not an attractive empiric choice for a gram-negative bloodstream infection here even before the Salmonella result.
What Cannot Be Compared
Two cells in different rows cannot be compared as if they measured the same thing. Ceftriaxone at 91% for E. coli and 100% for Salmonella come from 1,842 and 19 isolates, and from different patients with different infections, mostly urinary for E. coli. The difference does not mean ceftriaxone is better against Salmonella than against E. coli in any useful sense.
What a Better Row Would Need
The Salmonella row would be more useful if it combined more data. Some hospitals pool two or three years of isolates for uncommon organisms until they reach 30, and label the row with the period covered; others add their region's surveillance data with a note. Either approach would give the stewardship committee a steadier number. Neither was done for 2025, and the reading cannot pretend otherwise. When the row is thin, a clinician can also check state or national surveillance summaries, which collect far more isolates, before relying on a local percentage for a serious infection.
Back to the Case
On Thursday night, before any culture result, the table supported ceftriaxone as the empiric choice for possible Salmonella bacteremia, with the caution that the Salmonella row is thin. It said nothing about Listeria, which does not appear in the table and for which the choice of ampicillin rests on known intrinsic resistance to cephalosporins rather than local data. On Sunday, when R.A.'s own isolate was reported, the antibiogram stopped mattering for R.A.: the patient's susceptibility report replaces the hospital's averages. The isolate's ciprofloxacin result, intermediate, fits the 84% column value but is a fact about this organism, not an estimate. The order of reading matters for next year too: the stewardship committee will add R.A.'s isolate to the 2026 row, which will still be thin, so the note under the table is worth reading every time the row is used.
References
Clinical and Laboratory Standards Institute. (2022). Analysis and presentation of cumulative antimicrobial susceptibility test data (5th ed., CLSI guideline M39).
PA 514 Week 6 instructions, in plain terms
For the sixth week you read a cumulative antibiogram and explain what it can and cannot tell a clinician about one patient. Begin by describing the document: the hospital, the period covered, which units were combined, the isolate rule and who published it. Reproduce the rows relevant to your case in a table. Read at least one row across and one column down, and say what each reading suggests about empiric choices. Then check the isolate count behind each percentage and cite the standard for how many isolates are needed for a reliable figure. Explain why percentages from different organisms or sources are not directly comparable. Suggest how a weak row could be made more useful. Close by returning to your case and stating when the antibiogram guided the decision and when the patient's own culture replaced it.
How this PA 514 Week 6 example is built
The paper first describes the table: a regional hospital, all units combined for 2025, first isolate per patient, published in March 2026, with the intensive care version set aside because the patient was on a ward. Table 1 shows percent susceptible for E. coli, Klebsiella, Proteus and Salmonella against four drugs, with intrinsic resistance marked. The Salmonella row is read across, favoring ceftriaxone. A section on the count beside the row cites CLSI M39 and shows that one more resistant isolate would drop 100% to 95%. The ciprofloxacin column is read down from 76 to 92%. A comparison section explains why 91% from 1,842 isolates and 100% from 19 measure different things. Pooling several years is proposed, and the close places the table at two hours, Thursday night and Sunday.
Reading the PA 514 Week 6 grading rubric
The rubric rewards reading the table correctly before anything else, so misreading a percentage, the isolate rule or the period covered costs the most. Faculty then look for attention to isolate numbers: a paper that treats a row built on very few isolates with the same confidence as a large one loses a substantial share. Credit goes to a row read across and a column read down, each with a clear clinical meaning. Comparisons between rows earn points only when their limits are explained. The suggested improvement is marked on whether it would actually address the weakness identified. The return to the case is weighted on timing, showing that a patient's own susceptibility report supersedes the hospital's figures once it exists. A titled APA table and a cited preparation standard complete the marks.
PA 514 Week 6 help from the desk
A common way to lose points on this exercise is reading percentages as if every row were equally reliable. Send the antibiogram your course provides and your case, and the custom sample will describe the table's period and rules, reproduce the rows that matter and read them in both directions. Each percentage is checked against its isolate count and the preparation standard your instructor cites. Where your table has footnotes or intrinsic resistance markers, the sample explains what they change. The improvement section suggests a fix suited to your hospital's data, such as pooled years or regional surveillance. The final section places the table in your case's timeline. Treat the sample as a reading model, and check every figure against the table you were actually given.
Get a PA-514 Week 6 example written to your instructions
Send the Week 6 instructions along with the susceptibility table your classroom posted, since a grid from somewhere else cannot stand in for it. A custom example is returned inside 24 to 48 hours, reading your own table cell by cell against your case. The first one is free, and a supplied worksheet is filled in as issued.
More PA 514 papers and MPAS samples
- PA 514 Week 1: Exposure-First Discussion Post
- PA 514 Week 2: Exposure History Timeline
- PA 514 Week 3: Incubation Window Analysis
- PA 514 Week 4: Empiric Coverage Rationale
- PA 514 Week 5: Culture Narrowing Memo
- PA 514 Week 7: Stop Date Justification
- PA 514 Week 8: Reportable Condition Brief
- PA 512 Week 6: TNM Staging Worksheet
- PA 510 Week 6: Pigmented Lesion Evaluation
- PA 505 Week 6: Substance Use History Brief
- PA 504 Week 6: Collateral History Brief
PA 514 Week 6 questions, answered
Our classroom posts a hospital-wide table and a unit-level one.
Then both get used and the piece says which question each answers. A unit table usually describes a population with more exposure behind it, so the two grids disagree in a direction worth a sentence. Where they conflict, the finished example names which figure it is relying on for the case and why, rather than averaging the two together.
What does the isolate count actually change?
It changes how much weight a percentage can carry. A figure resting on a small number of isolates moves a great deal from one period to the next, so the finished piece treats it as an indication rather than as a measurement, and the sentence using that figure says as much. Rubrics here often give that sentence a row.
Is the table enough on its own?
Rarely, and most sections say so in the instructions. The grid describes what one laboratory saw, not what is in the case in front of you, so it is read alongside the exposure account and the report if one has arrived. A piece treating the table as the whole answer tends to lose the application marks rather than the reading ones.
Where can I find a free PA 514 Week 6 sample paper?
The complete PA 514 Week 6 antibiogram reading is on this page, with the four-row table, the isolate count check and the return to the case at two times.
Why does the PA 514 Week 6 sample distrust the Salmonella row?
It rests on 19 isolates, below the 30 the CLSI M39 guideline recommends, so a single additional resistant isolate would shift the figure noticeably.