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Herein, we compared the antimicrobial susceptibility, mechanisms of resistance, and the virulence profile of <jats:italic>Klebsiella<\/jats:italic> spp. from admitted and postmortem children.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Antimicrobial susceptibility and virulence factors of <jats:italic>Klebsiella<\/jats:italic> spp. recovered from blood samples collected upon admission to the hospital (<jats:italic>n\u2009=<\/jats:italic>\u00a088) and postmortem blood (<jats:italic>n\u2009=<\/jats:italic>\u00a023) from children &lt;\u20095\u2009years were assessed by disk diffusion and multiplex PCR.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p><jats:italic>Klebsiella<\/jats:italic> isolates from postmortem blood were likely to be ceftriaxone resistant (69.6%, 16\/23 vs. 48.9%, 43\/88, <jats:italic>p<\/jats:italic>\u2009=\u20090.045) or extended-spectrum \u03b2-lactamase (ESBL) producers (60.9%, 14\/23 vs. 25%, 22\/88, <jats:italic>p\u2009=<\/jats:italic>\u00a00.001) compared to those from admitted children. bla<jats:sub>CTX-M-15<\/jats:sub> was the most frequent ESBL gene: 65.3%, 9\/14 in postmortem isolates and 22.7% (5\/22) from admitted children. We found higher frequency of genes associated with hypermucoviscosity phenotype and invasin in postmortem isolates than those from admitted children: rmpA (30.4%; 7\/23 vs. 9.1%, 8\/88, <jats:italic>p\u2009=<\/jats:italic>\u00a00.011), <jats:italic>wzi-K1<\/jats:italic> (34.7%; 8\/23 vs. 8%; 7\/88, <jats:italic>p\u2009=<\/jats:italic>\u00a00.002) and traT (60.8%; 14\/23 vs. 10.2%; 9\/88, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), respectively. Additionally, serine protease auto-transporters of Enterobacteriaceae were detected from 1.8% (<jats:italic>pic<\/jats:italic>) to 12.6% (<jats:italic>pet)<\/jats:italic> among all isolates. <jats:italic>Klebsiella<\/jats:italic> case fatality rate was 30.7% (23\/75).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Multidrug resistant <jats:italic>Klebsiella<\/jats:italic> spp. harboring genes associated with hypermucoviscosity phenotype has emerged in Mozambique causing invasive fatal disease in children; highlighting the urgent need for prompt diagnosis, appropriate treatment and effective preventive measures for infection control.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06245-x","type":"journal-article","created":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T07:03:08Z","timestamp":1622876588000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Klebsiella spp. cause severe and fatal disease in Mozambican children: antimicrobial resistance profile and molecular characterization"],"prefix":"10.1186","volume":"21","author":[{"given":"Ars\u00e9nia J.","family":"Massinga","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcelino","family":"Garrine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Augusto","family":"Messa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00e9lio A.","family":"Nobela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Boisen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Massora","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"An\u00e9lsio","family":"Cossa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosauro","family":"Varo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ant\u00f3nio","family":"Sitoe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Carlos","family":"Hurtado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaume","family":"Ordi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9lio","family":"Mucavele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tacilta","family":"Nhampossa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert F.","family":"Breiman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia G.","family":"Whitney","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dianna M.","family":"Blau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quique","family":"Bassat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00e1cio","family":"Mandomando","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,5]]},"reference":[{"key":"6245_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0140754","volume":"10","author":"TC Hendrik","year":"2015","unstructured":"Hendrik TC, Voorintholt AF, Vos MC. 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The CHAMPS was reviewed and approved by the CISM\u2019s Institutional Ethics Committee for Health \u2013 CIBS-CISM and the CNBS (Ref: 285\/CNBS\/16 of September 05, 2016).The isolates included in this research were obtained from participants who were enrolled in the IBD and CHAMPS, and only if the parents, caretaker or legal guardians accepted to participate and sign an informed consent.The IBD and CHAMPS protocol and its methods were performed in accordance with the Declaration of Helsinki and Good Clinical and Laboratory Practices.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"526"}}