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* 1. Please rate (1-not confident, 5- very confident) your confidence in:

  (1) Not Confident (3) Confident (5) Very Confident
Describing the evolving epidemiology and resistance mechanisms of Gram-negative pathogens that commonly cause hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP)
Implementing the latest evidence-based diagnostic and therapeutic approaches when managing patients with HABP/VABP caused by multidrug-resistant (MDR) Gram-negative bacteria
Differentiating the pharmacology and antibacterial activity of newer antimicrobial agents targeting MDR Gram-negative bacteria
Evaluating strategies to guide antimicrobial selection and pathogen-specific therapy to optimize clinical and economic outcomes of patients with HABP/VABP

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* 2. Which of the following pathogens is most likely to be associated with late HABP (>5 days) versus early HABP?

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* 3. Which of the following antimicrobials would be preferred for treatment of HABP caused by KPC-producing E. coli?

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* 4. Risk factors for a multidrug-resistant Gram-negative infection include all of the following except:

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* 5. A 48-year-old who was admitted to the hospital and intubated 5 days ago following a motor vehicle accident is diagnosed with VABP. A rapid diagnostic test on a BAL sample reveals ESBL-producing K. pneumoniae. What do you do next?

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* 6. A 57-year-old man with a history of COPD is hospitalized due to a severe exacerbation and requires mechanical ventilation. He was previously hospitalized 6 weeks ago for a COPD exacerbation and was successfully treated with piperacillin-tazobactam. After 3 days during this current hospitalization, his condition worsens as he develops fever and increased sputum production. His WBC is 18,000/mm3 and is initiated empiric therapy with piperacillin-tazobactam. After 48 hours, he shows little improvement and culture and susceptibility results from an endotracheal aspirate sample reveal carbapenem-resistant K. pneumoniae. The next best course of action is to:

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* 7. Which of the following newer antimicrobials exhibits in vitro activity against metallo-beta-lactamases?

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* 8. A 71-year-old woman in the ICU develops VABP that is suspected to be caused by P. aeruginosa. The unit-specific antibiogram reveals high levels of resistance to piperacillin-tazobactam, ceftazidime, aztreonam, fluoroquinolones, and meropenem. Which of the following would be the least appropriate treatment option for this infection suspected to be caused by difficult-to-treat P. aeruginosa?

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* 9. A 64-year-old woman who has been intubated for 7 days is diagnosed with VABP and initiated empiric therapy with vancomycin and meropenem while an endotracheal aspirate sample is submitted for culture and susceptibility testing. After 72 hours, her vital signs improve and culture results reveal ESBL-producing E. coli. The next best course of action is to:

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* 10. (Optional) Name and Degree

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