A 54-yr-old man with C6 quadriplegia and a neurogenic bowel and bladder was evaluated for clearance of a urinary tract infection after treatment for organisms susceptible to the antibiotics used, and an organism resistant to all antibiotics on the panel grew on the initial follow-up urine culture. Multidrug-resistant organisms present increasing challenges and risks in the management of the neurogenic bladder in patients with spinal cord injury. In an effort to control and reduce the impact and risk associated with these organisms, management methods of the neurogenic bladder and infection control policies should be adjusted according to guidelines from the Centers for Disease Control and related research; such policies could include surveillance for multidrug-resistant organisms and isolation of patients who test positive for these organisms.