Journal
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
Volume 74, Issue 5, Pages 1223-1232Publisher
OXFORD UNIV PRESS
DOI: 10.1093/jac/dkz032
Keywords
-
Funding
- Wellcome Trust [098051, 101113/Z/13/E]
- National Institutes of Health through the H3Africa Bioinformatics Network (H3ABioNet) [U41HG006941]
- Quadram Institute Bioscience BBSRC [BB/R012504/1]
- Food Standards Fellowship [FS101185]
- BBSRC [BBS/E/F/000PR10348] Funding Source: UKRI
Ask authors/readers for more resources
Objectives: ESBL-producing Klebsiella pneumoniae (KPN) pose a major threat to human health globally. We carried out a WGS study to understand the genetic background of ESBL-producing KPN in Malawi and place them in the context of other global isolates. Methods: We sequenced genomes of 72 invasive and carriage KPN isolates collected from patients admitted to Queen Elizabeth Central Hospital, Blantyre, Malawi. We performed phylogenetic and population structure analyses on these and previously published genomes from Kenya (n=66) and from outside sub-Saharan Africa (n=67). We screened for presence of antimicrobial resistance (AMR) genetic determinants and carried out association analyses by genomic sequence cluster, AMR phenotype and time. Results: Malawian isolates fit within the global population structure of KPN, clustering into the major lineages of KpI, KpII and KpIII. KpI isolates from Malawi were more related to those from Kenya, with both collections exhibiting more clonality than isolates from the rest of the world. We identified multiple ESBL genes, including bla(CTX-M-15), several bla(SHV), bla(TEM-63) and bla(OXA-10), and other AMR genes, across diverse lineages of the KPN isolates from Malawi. No carbapenem resistance genes were detected; however, we detected IncFII and IncFIB plasmids that were similar to the carbapenem resistance-associated plasmid pNDM-mar. Conclusions: There are multiple ESBL genes across diverse KPN lineages in Malawi and plasmids in circulation that are capable of carrying carbapenem resistance. Unless appropriate interventions are rapidly put in place, these may lead to a high burden of locally untreatable infection in vulnerable populations.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available