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We describe a 16-year-old neutropenic patient from the Middle East with bloodstream infection caused by two carbapenemase-producingEscherichia coli isolates that we characterized by whole-genome sequencing. While one displayed meropenem resistance and wasbla NDM positive, the other demonstrated meropenem susceptibility yet harboredbla OXA181 (which encodes abla OXA48 -like enzyme). This report highlights the challenge of laboratory detection ofbla OXA48 -like enzymes and the clinical implications of genotypic resistance detection in carbapenemase-producingEnterobacteriaceae .

antimicrobial agents and chemotherapy

An Immunocompromised Child with Bloodstream Infection Caused by Two Escherichia coli Strains, One Harboring NDM-5 and the Other Harboring OXA-48-Like Carbapenemase