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Stenotrophomonas maltophilia is an emerging pathogen that can be extremely difficult to treat due to intrinsic antimicrobial resistance to aminoglycosides, fosfomycin, tetracycline, and most beta-lactam antibiotics including carbapenems. The treatment of choice is usually trimethoprim-sulfamethoxazole or fluoroquinolones, but once resistance to these agents is acquired, treatment can be exceedingly problematic. Beta-lactam resistance in S. maltophilia is mediated by the inducible L1 and L2 beta-lactamases. The L1 enzyme is a metallo-beta-lactamase that carries the usual resistance to all beta-lactamase inhibitors and the ability to hydrolyze all beta-lactams except aztreonam. Given their prior clinical case wherein prolonged S. maltophilia …