A 13-year old neutropenic boy succumbed to bacteremia and sepsis with a Pseudomonas aeruginosa strain that rapidly developed resistance to carbapenems during meropenem monotherapy. Whole genome sequencing of the susceptible and resistant blood culture isolates revealed the meropenem-resistant phenotype to be caused by truncation of the OprD gene, which added to a preexisting inactivated mexR gene.
From the *Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
†Princess Maxima Centre for Pediatric Oncology, Utrecht, The Netherlands
‡Department of Pediatrics, Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
Accepted for publication October 23, 2018.
The authors have no funding or conflicts of interest to disclose.
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Address for correspondence: Rob J. Rentenaar, MD, PhD, Department of Medical Microbiology G04.643, University Medical Centre Utrecht, PO box 85500, 3508GA Utrecht, The Netherlands. E-mail: email@example.com.