Since all of the B-lactams that you have tested are susceptible to hydrolysis by PAESBL-1, the hospital will not be able to use a single 8-lactam to combat this P. aeruginosa isolate. You need to consider alternative strategies. From the following list, select all of the strategies that might successfully overcome the broad substrate specificity PAESBL-1: Check all that apply. using multiple B-lactams simultaneously (e.g., rather than treating with amoxicillin alone, treat with the three B-lactams: amoxicillin, cephalothin, and imipenem). O using a reversible inhibitor of PAESBL-1 instead of a 8-lactam. Treat future infections by O combining a reversible inhibitor of PAESBL-1 with one or more 8-lactams. O using an irreversible inhibitor of PaESBL-1 instead of a B-lactam. O combining an irreversible inhibitor of PAESBL-1 with one or more -lactams. O O O O All of the kinetics work you performed in Parts F through P has allowed you to determine the values of kcat and KM of your enzyme for the substrate amoxicillin. You repeat all of these experiments with a series of additional ß- lactam substrates, hoping to determine which of the B-lactams are more or less susceptible to hydrolysis by this newly discovered B-lactamase enzyme. kicat (s) Км (uM) Antibiotic Amoxicillin 130 Cephalothin 1,000 6,000 Cefotaxime 14 7,900 Ceftazidime 2.5 20,000 Aztreonam 3.5 5,000 Imipenem 0.09 2.9 "Data based on published data for GES-14 in Table 2 from Delbrück H, Bogaerts P, Kupper MB, Rezende de Castro R, Bennink S, Glupczynski Y, Galleni M, Hoffmann KM, Bebrone C. Kinetic and crystallographic studies of extended-spectrum GES-11, GES-12, and GES-14 B-lactamases. Antimicrob Agents Chemother. 2012 Nov:56(11):5618.

Since all of the B-lactams that you have tested are susceptible to hydrolysis by PAESBL-1, the hospital will not be able to use a single 8-lactam to combat this P. aeruginosa isolate. You need to consider alternative strategies. From the following list, select all of the strategies that might successfully overcome the broad substrate specificity PAESBL-1: Check all that apply. using multiple B-lactams simultaneously (e.g., rather than treating with amoxicillin alone, treat with the three B-lactams: amoxicillin, cephalothin, and imipenem). O using a reversible inhibitor of PAESBL-1 instead of a 8-lactam. Treat future infections by O combining a reversible inhibitor of PAESBL-1 with one or more 8-lactams. O using an irreversible inhibitor of PaESBL-1 instead of a B-lactam. O combining an irreversible inhibitor of PAESBL-1 with one or more -lactams. O O O O All of the kinetics work you performed in Parts F through P has allowed you to determine the values of kcat and KM of your enzyme for the substrate amoxicillin. You repeat all of these experiments with a series of additional ß- lactam substrates, hoping to determine which of the B-lactams are more or less susceptible to hydrolysis by this newly discovered B-lactamase enzyme. kicat (s) Км (uM) Antibiotic Amoxicillin 130 Cephalothin 1,000 6,000 Cefotaxime 14 7,900 Ceftazidime 2.5 20,000 Aztreonam 3.5 5,000 Imipenem 0.09 2.9 "Data based on published data for GES-14 in Table 2 from Delbrück H, Bogaerts P, Kupper MB, Rezende de Castro R, Bennink S, Glupczynski Y, Galleni M, Hoffmann KM, Bebrone C. Kinetic and crystallographic studies of extended-spectrum GES-11, GES-12, and GES-14 B-lactamases. Antimicrob Agents Chemother. 2012 Nov:56(11):5618.

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