{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:43:11Z","timestamp":1790034191003,"version":"4.0.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Wits-VIDA"},{"DOI":"10.13039\/501100001336","name":"University of the Witwatersrand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001336","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Faculty Research Committee Individual Research","award":["2023"],"award-info":[{"award-number":["2023"]}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinician Researcher Development Programme"},{"name":"Public Health Enhancement Fund"},{"name":"South African National Department of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is a paucity of information on the burden of Klebsiella pneumoniae invasive disease (KPn-ID) in Africa. We conducted a multicentre, observational study on the clinical and microbiological epidemiology of KPn-ID in hospitalized adults in South Africa, focusing on clinical outcomes and KPn susceptibility profiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Surveillance for culture-confirmed KPn from blood and CSF was undertaken from 15 May 2023 to 14 May 2024. Phenotypic antimicrobial susceptibility was analysed, and the presence of carbapenemases was assessed with a lateral flow assay test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We enrolled 524 of 617 individuals with KPn-ID. The median age was 48 (IQR: 35\u201361) years, and 84.4% (442\/524) were presumed healthcare-associated infections. Comorbidities included HIV (26.9%; 141\/524) and diabetes mellitus (16.4%; 86\/524). There was a high prevalence of carbapenem resistance (55.0%; 288\/524), with the OXA-48 carbapenemase detected in 71.5% (181\/253), and OXA-48 and NDM co-detected in 20.9% (53\/253) of tested isolates. Colistin resistance was detected in 7.6% (19\/251) of tested isolates. The in-hospital case fatality risk (CFR) was 56.5% (296\/524). Urethral catheterization [adjusted odds ratio (aOR) 3.30; 95% CI: 1.51\u20137.23] and an admission quick sepsis-related organ failure assessment score of 1 to 3 (aOR 2.14; 95% CI: 1.25\u20133.68) were independently associated with in-hospital death. Achieving source control was associated with lower odds of death (aOR 0.18; 95% CI: 0.10\u20130.30).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We observed a high prevalence of MDR and high CFR in adults with KPn-ID. These data show the urgent need for strategies to mitigate KPn-ID in settings such as ours.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jacamr\/dlag003","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T12:39:12Z","timestamp":1768394352000},"source":"Crossref","is-referenced-by-count":5,"title":["Clinical and microbiological epidemiology of\n                    <i>Klebsiella pneumoniae<\/i>\n                    invasive disease in hospitalized adults in Johannesburg, South Africa: a multicentre observational study"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-021X","authenticated-orcid":false,"given":"Denasha L","family":"Reddy","sequence":"first","affiliation":[{"name":"South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand , Chris Hani Road, Diepkloof, Soweto, Johannesburg 1864 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