Table 1 Epidemiological data and antimicrobial susceptibility results of KPC-Kp resistant to ceftazidime-avibactam detected in the ICU of our hospital in both patients (year 2020) and environmental (July-September 2020) samples.

From: ICU environment as a reservoir of KPC-ST307-Klebsiella pneumoniae high-risk clone resistant to ceftazidime-avibactam

Patients / Sinks (ICU Room)

Origin

Length of stay ay ICU (days)

CZA exposure duration (time of culture)

MIC (mg/L)

KPC allele

PT4

AZT

FEP

C/T

CZA

IMI

IMR

MER

MEV

FDC

AZA

FTB

TGC

ERV

COL

FOS

AMK

TOB

Patient 1 (2, 4)

Rectal

121 (75) days

14 (1) days

> 32/4

> 32

> 16

> 8/4

2/4

16

0.25

8

≤ 0.06/8

0.5

≤ 0.25/4

0.25/4

≤ 0.5

0.5

> 16

≤ 16

≤2

> 4

KPC-3

Rectal

14 (6) days

> 32/4

> 32

16

> 8/4

8/4

≤ 1

0.25

≤ 0.12

≤ 0.06/8

1

0.5/4

1/4

≤ 0.5

0.25

8

≤ 16

16

> 4

KPC-46

Patient 2 (7)

Urine

91 (61) days

0

> 32/4

> 32

> 16

> 8/4

1/4

> 8

0.5

> 16

≤ 0.06/8

0.5

≤ 0.25/4

0.5/4

≤ 0.5

> 0.5

16

32

8

> 4

KPC-3

Rectal

6 (6) days

> 32/4

> 32

> 16

> 8/4

2/4

> 8

0.5

> 16

≤ 0.06/8

0.5

≤ 0.25/4

0.5/4

≤ 0.5

0.5

≤ 0.5

≤ 16

4

> 4

KPC-3

Rectal

6 (14) days

> 32/4

> 32

> 16

> 8/4

16/4

≤ 1

0.25/4

≤ 0.12

≤ 0.06/8

2

≤ 0.25/4

0.5/4

1

> 0.5

> 16

32

4

> 4

KPC-53

Patient 3 (6)

Rectal

109 (76) days

0

> 32/4

> 32

> 16

> 8/4

2/4

> 8

0.25/4

> 16

≤ 0.06/8

1

≤ 0.25/4

0.5/4

≤ 0.5

> 0.5

> 16

≤ 16

4

> 4

KPC-3

Rectal

11 (8) days

32/4

32

8

8/4

8/4

≤ 1

0.25/4

≤ 0.12

≤ 0.06/8

2

≤ 0.25/4

0.5/4

1

> 0.5

16

≤ 16

≤2

> 4

KPC-66

Patient 4 (2)

Rectal

129 (67) days

0

> 32/4

> 32

> 16

> 8/4

2/4

8

0.25/4

16

≤ 0.06/8

1

≤ 0.25/4

0.25–0.5

≤ 0.5

0.5

≤ 0.5

≤ 16

4

> 4

KPC-3

Blood

15 (24) days

32/4

> 32

8

8/4

8/4

≤ 1

0.25/4

≤ 0.12

≤ 0.06/8

2

≤ 0.25/4

0.5/4

1

0.5

≤ 0.5

≤ 16

≤2

> 4

KPC-92

Patient 5 (4)

Rectal

79 (73) days

2 (16) days

> 32/4

> 32

> 16

> 8/4

> 16/4

2

2/4

16

4/8

8

2/4

16/4

1

> 0.5

16

> 64

4

> 4

KPC-150

Patient 6 (12 A)

Rectal

72 (2) days

14 (5) days

> 32/4

> 32

> 16

> 8/4

8/4

≤ 1

0.25/4

≤ 0.12

≤ 0.06/8

0.5

≤ 0.25/4

0.25/4

1

>’0.5

≤ 0.5

≤ 16

4

> 4

KPC-92

Patient 7 (12B)

Rectal

58 (56) days

No treated

> 32/4

> 32

> 16

> 8/4

> 16/4

4

1/4

4

1/8

4

1/4

8/4

≤ 0.5

0.5

≤ 0.5

> 64

4

> 4

KPC-62

Bronchial aspirate

> 32/4

> 32

> 16

> 8/4

16/4

4

2/4

8

2/8

8

1/4

8/4

≤ 0.5

0.5

≤ 0.5

> 64

4

> 4

KPC-62

Patient 8 (13B)

Rectal

89 (32) days

No treated

> 32/4

> 32

> 16

> 8/4

16/4

8

1/4

4

1/8

8

1/4

8/4

≤ 0.5

0.5

≤ 0.5

> 64

4

> 4

KPC-62

Urine

> 32/4

> 32

> 16

> 8/4

> 16/4

8

0.25/4

8

0.25/8

> 8

1/4

8/4

≤ 0.5

0.5

≤ 0.5

> 64

8

> 4

KPC-62

Rectal

> 32/4

> 32

> 16

> 8/4

> 16/4

8

0.25/4

8

0.5/8

8

1/4

8/4

≤ 0.5

0.5

≤ 0.5

> 64

8

> 4

KPC-62

Patient 9 (14B)

Rectal

49 (29) days

No treated

> 32/4

> 32

> 16

> 8/4

> 16/4

4

2/4

8

2/8

4

1/4

8/4

≤ 0.5

0.5

≤ 0.5

> 64

4

> 4

KPC-62

Urine

> 32/4

> 32

> 16

> 8/4

> 16/4

4

1/4

8

1/8

4

1/4

8/4

≤ 0.5

0.5

≤ 0.5

> 64

8

> 4

KPC-62

Patient 10 (13B)

Catheter

26 (19) days

No treated

> 32/4

> 32

> 16

> 8/4

> 16/4

8

0.25/4

8

0.25/8

8

1/4

8/4

≤ 0.5

0.5

≤ 0.5

> 64

4

> 4

KPC-62

Bronchial aspirate

> 32/4

> 32

> 16

> 8/4

> 16/4

8

2/4

8

2/8

4

1/4

8/4

≤ 0.5

0.5

≤ 0.5

> 64

4

> 4

KPC-62

Bronchial aspirate

> 32/4

> 32

> 16

> 8/4

> 16/4

8

1/4

8

2/8

> 8

1/4

8/4

≤ 0.5

0.5

≤ 0.5

> 64

4

> 4

KPC-62

Rectal

> 32/4

> 32

> 16

> 8/4

> 16/4

4

1/4

8

2/8

8

1/4

8/4

≤ 0.5

0.5

≤ 0.5

> 64

4

> 4

KPC-62

Sink 1 (7)

Drain

-

-

> 32/4

> 32

> 16

> 8/4

16/4

2

0.25/4

≤ 0.12

≤ 0.06/8

1

≤ 0.25/4

0.25/4

1

>’0.5

16

≤ 16

4

> 4

KPC-66

Sink 2 (10)

Siphon

-

-

> 32/4

> 32

> 16

> 8/4

16/4

2

2/4

8

4/8

4

0.5/4

16/4

1

>’0.5

≤ 0.5

> 64

32

> 4

KPC-92

  1. PT4  piperacillin-tazobactam, AZT aztreonam, FEP  cefepime, C/T  ceftolozane-tazobactam, CZA  ceftazidime-avibactam,IMI  imipenem, IMR imipenem-relebactam, MER  meropenem, MEV  meropenem-vaborbactam, FDC  cefiderocol, AZA  aztreonam-avibactam, FTB cefepime-taniborbactam, TGC  tigecycline, ERV  eravacycline, COL colistin, FOS  Fosfosmycin, AMK  amikacin, TOB  tobramycin.
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