Highlights ■ Carbapenem resistance rose sharply during the COVID-2019 pandemic, doubling from 2019 to 2020, while infection control practices prevented proportional increases in  healthcare-associated infections. ■ Genomic analyses revealed high diversity among blaKPC-positive isolates, with an expansion of sequence types and a predominance of sporadic non-outbreak clones throughout the pandemic period. ■ Shifts in mobile genetic elements and virulence markers occurred during the pandemic, including the emergence of the integrative and conjugative element of Klebsiella pneumoniae ICEKp4, changes in O-antigen […]