{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:53:09Z","timestamp":1781661189936,"version":"3.54.5"},"reference-count":30,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100003042","name":"Else Kr\u00f6ner-Fresenius Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Else Kr\u00f6ner Center W\u00fcrzburg"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Klebsiella pneumoniae is a cause of bloodstream infections in neonates and poses a major clinical challenge. Hence, we aimed to investigate molecular epidemiology, transmission dynamics, and underlying virulence and resistance patterns of invasive\/colonized K pneumoniae isolates from neonates admitted at the Bugando Medical Centre, Mwanza, Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective molecular epidemiology cohort study was conducted between January 2023 and June 2024. Automated resistance testing and Illumina whole genome sequencing were performed. Multilocus sequence typing, lipopolysaccharide (O) and capsule (K) typing, phylogenetic analysis, and annotation of resistance\/virulence genes (using Kleborate) were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Neonates (13 female and 11 male) had an average birth weight of 2545.8\u2005g. Retrieved isolates (n = 41) revealed high resistance rates for penicillins (ampicillin, 95.1% [39\/41]; piperacillin, 92.7% [38\/41]), cephalosporins (87.8% [36\/41] to 90.2% [37\/41]), and aminoglycosides (73.2%, 30\/41). Penicillin\u2013beta-lactamase inhibitor combinations increased susceptibility (ampicillin-sulbactam, 87.8% [36\/41]); piperacillin-tazobactam, 41.5% [17\/41]). Ciprofloxacin resistance was seen in 58.5% (24\/41), while carbapenems retained high activity (95.1%, 39\/41). Whole genome sequencing identified 16 multilocus sequence typing sequence types, with ST2390 (7\/41), ST48 (6\/41), and ST101 (5\/41) predominating. K- and O-typing identified KL107 (48.8%, 20\/41), KL113 (17.1%, 7\/41), and O1\u03b1\u03b2,2\u03b1 (56.1%, 23\/41) as the most prevalent. There was no sign of genotypic or phenotypic hypervirulence. Kleborate resistance scores confirmed 34 phenotypically positive extended-spectrum beta-lactamase isolates and 1 multidrug-resistant isolate. Phylogenetic analysis grouped isolates into 7 clusters, with evidence of intrahospital transmission in 5 and potential gut-to-bloodstream translocation in 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neonatal K pneumoniae isolates show high extended-spectrum beta-lactamase prevalence, limited virulence, and signs of hospital transmission, underscoring the urgent need for enhanced infection control and antimicrobial stewardship in African neonatal units.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiag253","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:46:43Z","timestamp":1778154403000},"source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology, Resistance, and Virulence of Neonatal\n                    <i>Klebsiella pneumoniae<\/i>\n                    Isolates From a Tertiary Hospital in Tanzania"],"prefix":"10.1093","author":[{"given":"Delfina R","family":"Msanga","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Child Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline A","family":"Minja","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences , Mwanza ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"H\u00e4rtel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital W\u00fcrzburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Claus","sequence":"additional","affiliation":[{"name":"Institute for Hygiene and Microbiology, University of W\u00fcrzburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen E","family":"Mshana","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences , Mwanza ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7277-2646","authenticated-orcid":false,"given":"Oliver","family":"Kurzai","sequence":"additional","affiliation":[{"name":"Institute for Hygiene and Microbiology, University of W\u00fcrzburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander M","family":"Aldejohann","sequence":"additional","affiliation":[{"name":"Institute for Hygiene and Microbiology, University of W\u00fcrzburg ,","place":["Germany"]},{"name":"Infection Control and Antimicrobial Stewardship Unit, University Hospital W\u00fcrzburg 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