Table 5.

Clinical Characteristics, Microbiology, and Resistance Mechanisms of Multidrug-Resistant Enterobacterales Responsible for Late Recurrent Colonization or Infection

Patient	Onset from Initial MDR-E Infection	Infection or Colonization	Type of MDR-E	Mechanisms of MDR-E Resistance	Median (Range) #cgSNP Between Initial and Recurrent Isolates	Outcome of Recurrence
CR-035	483 days	Purulent tracheobronchitis	CR-Kp	KPC-3, ST258	Initial (n = 1) vs late recurrent (n = 1) strains	No further recurrence
					4 SNP	Alive
CR-048	1213, 1268, 1274, 1304, and 1421 days	Bacteremia and pneumonia	CR-Kp	KPC-3, ST258	Initial (n = 2) vs late recurrent (n = 1) strains	Persistent colonization and multiple recurrent infections
					12 (11–13) SNP	Died 1422 days after initial infection (died from recurrent infection due to ceftazidime-avibactam–resistant KPC46-Kp)
CR-038	457, 583, 618, and 759 days	Respiratory and urinary colonization	CR-Kp	KPC-3, ST258	Initial (n = 4) vs late recurrent (n = 3) strains	Multiple recurrent colonization
					5 (1–7) SNP	Alive
CR-1092	191, 338, and 401 days	Respiratory colonization	CR-Kp	KPC-3, ST258	Initial (n = 1) vs late recurrent (n = 3) strains	Multiple recurrent colonization
					2 (1–4) SNP	Alive
CR-070	285, 911, 957, and 1224 days	Urinary tract infection	CefR-Escherichia coli	CTX-M15	Initial (n = 2) vs late recurrent (n = 2) strains	Multiple recurrent colonization
					17 (7–18) SNP	Alive
CR-047	202 days	Urinary colonization	CefR-ECC	CefR-ECC	Isolate not available	No further recurrence
				CTX-M-15 and ACT-16 group		Alive

Late recurrent colonization or infection was defined as >90 days after the initial infection with the same MDR-E.

Abbreviations: CefR-E, third-generation cephalosporin-resistant Enterobacterales; cg, core genome; CR, cephalosporin-resistant; ECC, Enterobacter cloacae complex; Kp, Klebsiella pneumoniae; Klebsiella pneumoniae carbapenemase; MDR-E, multidrug-resistant Enterobacterales; SNP, single-nucleotide polymorphism.