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In September 2010, a 74-year-old woman presented to the emergency department after acute onset of an ischemic stroke. During hospitalization she developed nosocomial pneumonia, which resulted in intubation and transfer to an intensive care unit (ICU). In the ICU she received multiple antibiotics, including piperacillin-tazobactam, cefepime, meropenem, and vancomycin. On her 15th day of hospitalization, a tracheostomy was performed due to her inability to be weaned from mechanical ventilation. Five days later, due to the persistence of respiratory distress, a culture of bronchial secretion was taken. The laboratory reported a K. pneumoniae isolate (isolate 3359) nonsusceptible to ciprofloxacin, amikacin,-lactams/-lactamase inhibitors, expanded-spectrum cephalosporins, imipenem, and ertapenem but susceptible to meropenem, tigecycline, and polymyxin B. The patient was continued on meropenem (2 g …