부산대학교 도서관

• We identified multiple New Delhi metallo-beta-lactamase 1 Klebsiella pneumoniae isolates in Ukrainian patients. • We detected isolates co-carrying OXA-48 and New Delhi metallo-beta-lactamase-1 carbapenemases. • Treatment choices were limited by the occurrence of multiresistant co-infections. • Sequencing results suggest partial transmission during primary care in Ukraine. We analyzed consecutive clinical cases of infections due to carbapenemase-producing gram-negative bacteria detected in war-wounded patients from Ukraine who were treated at one university medical center in southwest Germany between June and December 2022. The isolates of multiresistant gram-negative bacteria were subjected to a thorough microbiological characterization and whole genome sequencing (WGS). We identified five war-wounded Ukrainian patients who developed infections with New Delhi metallo-β-lactamase 1-positive Klebsiella pneumoniae. Two isolates also carried OXA-48 carbapenemases. The bacteria were resistant to novel antibiotics, such as ceftazidime/avibactam and cefiderocol. The used treatment strategies included combinations of ceftazidime/avibactam + aztreonam, colistin, or tigecycline. WGS suggested transmission during primary care in Ukraine. We conclude that there is an urgent need for thorough surveillance of multiresistant pathogens in patients from war zones. [ABSTRACT FROM AUTHOR]