Whole-Genome Sequencing of Difficult-to-Treat Pseudomonas aeruginosa for Detection of Tandem Guiana Extended Spectrum Beta-Lactamases

We describe a patient case with recent hospitalization outside of the U.S. with subsequent infection involving Pseudomonas aeruginosa (PA) with difficult to treat resistance (DTR-PA). This isolate had a carbapenemase less often encountered in the U.S. We describe the benefits of whole genome sequencing (WGS) and the infection control- and pharmacy-related challenges in managing patients with critical yet uncommon antimicrobial resistance (AMR).