Outbreak of NDM-1-producing Klebsiella pneumoniae in the intensive care unit during the COVID-19 pandemic: Another nightmare.

• A carbapenemase NDM-1-producing K. pneumoniae outbreak occurred during COVID-19 epidemic. • The nonoptimal application of bio-cleaning procedures may have contributed to the outbreak. • Workload, patient severity and inappropriate glove excessive use may have contributed additionally. An outbreak of Klebsiella pneumoniae producing the carbapenemase NDM-1 occurred in our ICU during the last COVID-19 wave. Twelve patients were tested positive, seven remained asymptomatic whereas 5 developed an infection. Resistome and in silico multilocus sequence typing confirmed the clonal origin of the strains. The identification of a possible environmental reservoir suggested that difficulties in observing optimal bio-cleaning procedures due to workload and exhaustion contributed to the outbreak besides the inappropriate excessive glove use. [ABSTRACT FROM AUTHOR]