Table I.
Characteristics of clinical carbapenemase-producing Enterobacterales (CPE) isolates from COVID-19 ICU
| Characteristic | Patient no. |
||||||
|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | |
| Whole-genome sequencing ID | 21-004-0626 | 21-004-0642 | MI21812817 | 21-004-0654 | 21-004-0652 | 21-004-0651 | 21-004-0653 |
| Organism | Klebsiella pneumoniae | Klebsiella pneumoniae | Klebsiella pneumoniae | Klebsiella pneumoniae | Klebsiella pneumoniae | Klebsiella pneumoniae | Klebsiella pneumoniae |
| Resistance genotype | OXA-48 | OXA-48 | OXA-48 | OXA-48 | OXA-48 | OXA-48 | OXA-48 |
| CTX-M-15 | CTX-M-15 | CTX-M-15 | CTX-M-15 | CTX-M-15 | CTX-M-15 | CTX-M-15 | |
| aac (3)-IId | aac (3)-IId | aac (3)-IId | aac (3)-IId | aac (3)-IId | aac (3)-IId | aac (3)-IId | |
| Plasmid replicon type | IncL | IncL | IncL | IncL | IncL | IncL | IncL |
| Porin mutations | ompK35/ompK36 | ompK35/ompK36 | ompK35/ompK36 | ompK35/ompK36 | ompK35/ompK36 | ompK35/ompK36 | ompK35/ompK36 |
| Meropenem MIC (mg/L) | >32 | >32 | >32 | >32 | >32 | >32 | >32 |
| Sample type | Sputum | Sputum | Screen | Screen | Screen | Screen | Screen |
| Days from ICU admission to CPE detection | 24 | 5 | 13 | 6 | 9 | 10 | 5 |
| Prior MRO screen | Negative | Negative | Nil | Negative | Negative | Negative | Nil |
| Bed space common with other CPE patient | Y | Y | Y | Y | Y | Y | Y |
| Bed space common with positive environmental screen | N | Y | N | N | N | N | N |
| Mechanically ventilated | Y | Y | Y | Y | Y | Y | Y |
| Antibiotics received prior to CPE isolation | Piperacillin/tazobactam, flucloxacillin, cefepime | Piperacillin/tazobactam, clindamycin, vancomycin, metronidazole | Piperacillin/tazobactam, amoxicillin/clavulanate, vancomycin | Amoxicillin/clavulanate | Amoxicillin/clavulanate, piperacillin/tazobactam, cefepime | Ceftriaxone, piperacillin/tazobactam | Ceftriaxone, azithromycin |
CPE, carbapenemase-producing Enterobacterales; ECMO, extracorporeal membrane oxygenation; ICU, intensive care unit; MIC, minimum inhibitory concentration; MRO, multidrug-resistant organism; NA, not available; ompK35/ompK36, premature stop codon in the outer membrane porin gene ompK35 and insertion in loop 3 of ompK36.