{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T07:10:19Z","timestamp":1785827419167,"version":"3.56.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":43,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2022-03490"],"award-info":[{"award-number":["2022-03490"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>Multidrug-resistant (MDR) Gram-negative bacilli pose a significant threat in neonatal care. This study aimed to evaluate the point prevalence and molecular characteristics of intestinal MDR colonization in neonates at Muhimbili National Hospital, Tanzania.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>We conducted a point prevalence study with faecal samples from 51 neonates born \u226526\u2005weeks gestational age (41% girls, mean 31.6\u200a\u00b1\u200a3.8\u2005weeks) admitted to the neonatal intensive care unit (NICU) at Muhimbili National Hospital on 17 May 2022. The median age at sampling was 8\u2005days (interquartile range 11\u2005days). Samples were cultured on chromogenic agar, and positive colonies underwent antimicrobial susceptibility testing. Whole-genome sequencing and plasmid analysis using Optical DNA Mapping (ODM) were performed on carbapenem-resistant isolates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 51 neonates, 31 (60.7%) were colonized by ESBL-producing Klebsiella pneumoniae (EP-KP) and\/or Escherichia coli (EP-EC). Of these, 15 isolates were carbapenem-producing Enterobacteriaceae (CPE) harboring blaNDM-5, blaCTX-M-15, and eight also carried blaOXA-181. The most prevalent carbapenemase-producing Klebsiella pneumoniae (CP-KP) sequence type (ST) was ST437, part of the high-risk clonal complex CC11, while the most common carbapenemase-producing E. coli (CP-EC) was ST167. Both CP-KP and CP-EC were MDR isolates encoding blaCTX-M-15 and blaNDM-5. Optical DNA Mapping showed that the blaNDM-5 encoding plasmids in at least six carbapenem-producing isolates (four KP ST437 and two EC ST167) were similar, suggesting plasmid transfer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A high prevalence of colonization with high-risk clones was observed in neonates, highlighting the urgent need for strengthened MDR-surveillance, infection control, and antibiotic stewardship in the NICU at MNH.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaf179","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T07:23:51Z","timestamp":1760599431000},"source":"Crossref","is-referenced-by-count":3,"title":["Emergence of carbapenem-producing enterobacteriaceae (CPE) and other multidrug-resistant gram-negative bacteria in neonates at a tertiary-level NICU in Tanzania: a point prevalence study"],"prefix":"10.1093","volume":"7","author":[{"given":"H","family":"Naburi","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Child Health, Muhimbili University of Allied Sciences , Dar es Salaam ,","place":["Tanzania"]},{"name":"Department of Paediatrics and Child Health, Muhimbili National Hospital , Dar es Salaam ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Sewunet","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Clinical Microbiology, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0117-5369","authenticated-orcid":false,"given":"C","family":"Tellapragada","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Karolinska Institutet , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6396-5761","authenticated-orcid":false,"given":"N","family":"Nalitolela","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Muhimbili University of Allied Sciences , Dar es Salaam ,","place":["Tanzania"]},{"name":"Department of Paediatrics and Child Health, Muhimbili National Hospital , Dar es Salaam ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M S","family":"Wranne","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, Chalmers University of Technology , Gothenburg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Joachim","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Muhimbili University of Allied Sciences , Dar es Salaam ,","place":["Tanzania"]},{"name":"Department of Microbiology and Immunology, Muhimbili National Hospital , Dar es Salaam ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Kasubi","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Muhimbili University of Allied Sciences , Dar es Salaam ,","place":["Tanzania"]},{"name":"Department of Microbiology and Immunology, Muhimbili National Hospital , Dar es Salaam ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Mkony","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Muhimbili University of Allied Sciences , Dar es Salaam ,","place":["Tanzania"]},{"name":"Department of Paediatrics and Child Health, Muhimbili National Hospital , Dar es Salaam 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