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In sub-Saharan Africa, maternity wards represent high-risk settings where environmental contamination poses a direct threat to vulnerable mothers and neonates. Despite this, there is a significant lack of data integrating phenotypic resistance with whole-genome sequencing (WGS) to understand antimicrobial resistance (AMR) in these settings. This study characterized the AMR patterns and genomic features of ESBL-producing\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    and\n                    <jats:italic>Klebsiella<\/jats:italic>\n                    spp. isolated from maternity ward surfaces in Yaounde, Cameroon. A cross-sectional environmental study was conducted across four maternity wards. Isolates were identified via standard microbiological methods, and antimicrobial susceptibility testing against 13 antibiotics was performed following European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2024 guidelines. Short-read WGS was utilized to identify sequence types (STs), plasmid incompatibility groups, antibiotic resistance genes (ARGs), and virulence factors. Plasmid-ARG association networks were constructed to visualize resistance dynamics. Nineteen ESBL-producing\n                    <jats:italic>Enterobacterales<\/jats:italic>\n                    were identified, comprising 15\n                    <jats:italic>E. coli<\/jats:italic>\n                    and four\n                    <jats:italic>Klebsiella<\/jats:italic>\n                    spp. isolates. High levels of multidrug resistance were observed against ciprofloxacin, penicillins, and third-generation cephalosporins. While the isolates remained sensitive to colistin and imipenem, alarming resistance to meropenem was detected. Genomic analysis revealed the presence of globally disseminated high-risk lineages, including\n                    <jats:italic>E. coli<\/jats:italic>\n                    ST131, ST1193, and ST410, alongside\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    ST1324\n                    <jats:italic>and K. quasipneumoniae<\/jats:italic>\n                    ST489. Critical resistance determinants, including ESBLs, AmpC enzymes, and carbapenemases (\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM<\/jats:sub>\n                    ,\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>OXA-48-like<\/jats:sub>\n                    ), were associated with epidemic plasmids such as IncF, IncA\/C2, and IncL\/M. Additionally, the isolates harboured virulence factors characteristic of extraintestinal pathogenic\n                    <jats:italic>Enterobacterales<\/jats:italic>\n                    . The widespread presence of high-risk carbapenemase-producing clones on maternity ward surfaces identifies the hospital environment as a significant AMR reservoir in Yaounde. These findings highlight the urgent need for reinforced infection prevention and control (IPC) measures, robust antimicrobial stewardship, and the integration of genomic surveillance to safeguard highly susceptible maternal and neonatal populations from life-threatening infections.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-54772-x","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T14:24:15Z","timestamp":1780669455000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Whole-genome sequencing reveals high-risk ESBL and carbapenemase-producing Enterobacterales on maternity ward surfaces in Cameroon"],"prefix":"10.1038","volume":"16","author":[{"given":"Gabriel Cedric","family":"Bessala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germanie Delaisie","family":"Abomo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henri Rodrigue Njengoue","family":"Ngamaleu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Essiben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole E.","family":"Wheeler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle M. 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