Combined clonal and plasmid-mediated outbreak of carbapenemase-producing Enterobacterales, Lithuania, 2019–2020

This outbreak highlights the high transmissibility of CRE, and in particular KPC-producing K. pneumoniae in healthcare settings. The outbreak is further complicated by parallel clonal expansion and plasmid spread
including to other species. Early detection of outbreaks and close cooperation between healthcare units, clinicians and public health services are crucial to control the spread of CRE in the hospitalised patient
population. Moreover, this outbreak highlights the importance of early detection of CRE in countries and settings with low incidence. To improve early detection and the control of CRE high-risk clones, and to better
target control measures in healthcare facilities, there is a need for increased laboratory capacity in the European Union (EU)/European Economic Area (EEA) to support outbreak investigations and surveillance with real-time WGS in order to avoid further spread.