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The emergence of antimicrobial resistance (AMR) and multidrug resistance (MDR) among <jats:italic>Escherichia coli<\/jats:italic> and <jats:italic>Klebsiella pneumoniae<\/jats:italic>, especially through the production of extended spectrum <jats:italic>\u03b2<\/jats:italic>\u2010lactamases (ESBLs), limits therapeutic options and poses a significant public health threat. <jats:italic>Objective<\/jats:italic>. The aim of this study was to assess the phenotypic and genetic determinants of antimicrobial resistance of ESBL\u2010producing <jats:italic>Escherichia coli<\/jats:italic> and <jats:italic>Klebsiella pneumoniae<\/jats:italic> isolates from patient samples in two Kenyan Hospitals. <jats:italic>Methods<\/jats:italic>. We collected 138 <jats:italic>E. coli<\/jats:italic> and 127 <jats:italic>K. pneumoniae<\/jats:italic> isolates from various clinical specimens at the two health facilities from January 2020 to February 2021. The isolates\u2019 ESBL production and antibiotic susceptibility were phenotypically confirmed using a standard procedure. Molecular analysis was done through conventional polymerase chain reaction (PCR) with appropriate primers for <jats:italic>gad<\/jats:italic>A, <jats:italic>rpo<\/jats:italic>B, <jats:italic>bla<\/jats:italic><jats:sub>TEM<\/jats:sub>, <jats:italic>bla<\/jats:italic><jats:sub>SHV<\/jats:sub>, <jats:italic>bla<\/jats:italic><jats:sub>OXA<\/jats:sub>, <jats:italic>bla<\/jats:italic><jats:sub>CTX-M-group-1<\/jats:sub>, <jats:italic>bla<\/jats:italic><jats:sub>CTX-M-group-2<\/jats:sub>, <jats:italic>bla<\/jats:italic><jats:sub>CTX-M-group-9<\/jats:sub>, and <jats:italic>bla<\/jats:italic><jats:sub>CTX-M-group-8\/25<\/jats:sub> genes, sequencing and BLASTn analysis. <jats:italic>Results<\/jats:italic>. Most <jats:italic>E. coli<\/jats:italic> (82.6%) and <jats:italic>K. pneumoniae<\/jats:italic> (92.9%) isolates were ESBL producers, with the highest resistance was against ceftriaxone (69.6% among <jats:italic>E. coli<\/jats:italic> and 91.3% among <jats:italic>K. pneumoniae<\/jats:italic>) and amoxicillin\/clavulanic acid (70.9% among <jats:italic>K. pneumoniae<\/jats:italic>). The frequency of MDR was 39.9% among <jats:italic>E. coli<\/jats:italic> and 13.4% among <jats:italic>K. pneumoniae<\/jats:italic> isolates. The commonest MDR phenotypes among the <jats:italic>E. coli<\/jats:italic> isolates were CRO\u2010FEP\u2010AZM\u2010LVX and CRO\u2010AZM\u2010LVX, while the FOX\u2010CRO\u2010AMC\u2010MI\u2010TGC\u2010FM, FOX\u2010CRO\u2010FEP\u2010AMC\u2010TZP\u2010AZM\u2010LVX\u2010MI and CRO\u2010AMC\u2010TZP\u2010AZM\u2010MI were the most frequent among <jats:italic>K. pneumoniae<\/jats:italic> isolates. Notably, the FOX\u2010CRO\u2010FEP\u2010AMC\u2010TZP\u2010AZM\u2010LVX\u2010MI phenotype was observed in ESBL\u2010positive and ESBL\u2010negative <jats:italic>K. pneumoniae<\/jats:italic> isolates. The most frequent ESBL genes were <jats:italic>bla<\/jats:italic><jats:sub>TEM<\/jats:sub> (42%), <jats:italic>bla<\/jats:italic><jats:sub>SHV<\/jats:sub> (40.6%), and <jats:italic>bla<\/jats:italic><jats:sub>OXA<\/jats:sub> (36.2%) among <jats:italic>E. coli<\/jats:italic>, and <jats:italic>bla<\/jats:italic><jats:sub>TEM<\/jats:sub> (89%), <jats:italic>bla<\/jats:italic><jats:sub>SHV<\/jats:sub> (82.7%), <jats:italic>bla<\/jats:italic><jats:sub>OXA<\/jats:sub> (76.4%), and <jats:italic>bla<\/jats:italic><jats:sub>CTX-M-group-1<\/jats:sub> (72.5%) were most frequent ESBL genes among <jats:italic>K. pneumoniae<\/jats:italic> isolates. The <jats:italic>bla<\/jats:italic><jats:sub>SHV<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>OXA<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>TEM<\/jats:sub> genotypes were predominantly associated with FOX\u2010CRO\u2010FEP\u2010MEM and CRO\u2010FEP multidrug resistance (MDR) and CRO antimicrobial resistance (AMR) phenotypes, among <jats:italic>E. coli<\/jats:italic> isolates from Embu Level V (16.7%) and Kenyatta National Hospital (7.0%), respectively. <jats:italic>Conclusions<\/jats:italic>. The high proportion of ESBL\u2010producing <jats:italic>E. coli<\/jats:italic> and <jats:italic>K. pneumoniae<\/jats:italic> isolates increases the utilization of last\u2010resort antibiotics, jeopardizing antimicrobial chemotherapy. Furthermore, the antimicrobial resistance patterns exhibited towards extended\u2010spectrum cephalosporins, beta\u2010lactam\/beta\u2010lactamase inhibitor combinations, fluoroquinolones, and macrolides show the risk of co\u2010resistance associated with ESBL\u2010producing isolates responsible for MDR. Hence, there is a need for regular surveillance and implementation of infection prevention and control strategies and antimicrobial stewardship programs.<\/jats:p>","DOI":"10.1155\/2024\/7463899","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T15:05:08Z","timestamp":1707923108000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Phenotypic and Genotypic Characterization of Extended Spectrum Beta\u2010Lactamase\u2010Producing Clinical Isolates of <i>Escherichia coli<\/i> and <i>Klebsiella pneumoniae<\/i> in Two Kenyan Facilities: A National Referral and a Level Five Hospital"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2485-4591","authenticated-orcid":false,"given":"Sylvia M.","family":"Maveke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6328-486X","authenticated-orcid":false,"given":"Gabriel O.","family":"Aboge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia W.","family":"Kanja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred O.","family":"Mainga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naftaly","family":"Gachau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice W.","family":"Muchira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5604-9987","authenticated-orcid":false,"given":"Gervason A.","family":"Moriasi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"key":"e_1_2_15_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)02185-7"},{"key":"e_1_2_15_2_2","article-title":"The burden of bacterial antimicrobial resistance in the WHO European region in 2019: a cross-country systematic analysis","volume":"7","author":"European Antimicrobial Resistance Collaborators","year":"2022","journal-title":"The Lancet Public Health"},{"key":"e_1_2_15_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1135614"},{"key":"e_1_2_15_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics10050476"},{"key":"e_1_2_15_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-02186-2"},{"key":"e_1_2_15_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17176278"},{"key":"e_1_2_15_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics12020234"},{"key":"e_1_2_15_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.vmbf-0016-2015"},{"key":"e_1_2_15_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17238866"},{"key":"e_1_2_15_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-020-00800-y"},{"key":"e_1_2_15_11_2","unstructured":"Who Global Antimicrobial Resistance and Use Surveillance System 2021 Who Geneva Switzerland GLASS Report."},{"key":"e_1_2_15_12_2","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5153237"},{"key":"e_1_2_15_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-016-0117-4"},{"key":"e_1_2_15_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-021-00437-8"},{"key":"e_1_2_15_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.18.4.657-686.2005"},{"key":"e_1_2_15_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-018-3324-5"},{"key":"e_1_2_15_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR"},{"key":"e_1_2_15_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2018.0046"},{"key":"e_1_2_15_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-33093-8"},{"key":"e_1_2_15_20_2","volume-title":"Global Action Plan on Antimicrobial Resistance","author":"World Health Organization (WHO)","year":"2015"},{"key":"e_1_2_15_21_2","doi-asserted-by":"publisher","DOI":"10.18502\/ijm.v13i2.5978"},{"key":"e_1_2_15_22_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002521"},{"key":"e_1_2_15_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02724-0"},{"key":"e_1_2_15_24_2","volume-title":"Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data; Approved CLSI Guideline Document M39-A4","author":"Clinical Laboratory Standards Institute (CLSI)","year":"2022"},{"key":"e_1_2_15_25_2","volume-title":"Veterinary Epidemiologic Research. 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