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case_images: Changes in temperature and CRP of the patient during hospitalization and the changes of antimicrobial agents.
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case_images: However, on day 19, the patient experienced sudden fever (Figure 1), decreased pulse oxygen, accelerated heart rate and respiration, decreased blood pressure, cyanosis, and body speckle. C-reactive protein (CRP) (Figure 1) was measured at 30.14mg/L and procalcitonin (PCT) at 3.41ng/mL.
case_images: Aetiological examination of multidrug-resistant Klebsiella pneumoniae: (A) colonies; (B) Gram stain.
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case_images: On day 23, a blood culture revealed the presence of multidrug-resistant Klebsiella pneumoniae (Figure 2).
case_images: Rapid enzyme type detection (A) and combination susceptibility test in vitro (B and C).
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case_images: Subsequently, we conducted in vitro rapid carbapenemase type detection and combined drug susceptibility testing (Figure 3), which revealed that the bacterium primarily produced ESBL and OXA-48 carbapenemase.
case_images: mNGS Results of blood culture.
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case_images: Simultaneously, blood culture and metagenomics next-generation sequencing (mNGS) were performed (Table 2 and Figure 4).