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. 2023 Sep 13;45(2):137–143. doi: 10.1017/ice.2023.205

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© The Author(s) 2023

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.

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Figure 1. — Carbapenemase-producing Enterobacterales (CPE) surveillance workflow (see text for details). CPE isolates are notified to the infection control unit by means of active and passive patient surveillance. If >1 isolate from patients with epidemiological linkages is detected, a possible outbreak is declared. All isolates are sequenced locally using Illumina technology and analyzed by species. A probable outbreak is established when genomically linked isolates or matching plasmids harboring the same CPE gene are detected (see text for details). An outbreak is confirmed when there are both genomic and epidemiological linkages. Open circles show unrelated isolates based on genomic criteria. Note. CPE, carbapenemase-producing Enterobacterales; ICU, intensive care unit; KO, Klebsiella oxytoca; KP, Klebsiella pneumoniae; NDM-7, bla _NDM7; pCPE, plasmid harboring the CPE gene; WGS, whole-genome sequencing.