{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T06:34:11Z","timestamp":1777358051365,"version":"3.51.4"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004441","name":"Styrelsen f\u00f6r Internationellt Utvecklingssamarbete","doi-asserted-by":"publisher","award":["ISP 2017\/43:9"],"award-info":[{"award-number":["ISP 2017\/43:9"]}],"id":[{"id":"10.13039\/100004441","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Treating sepsis caused by high-priority\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      remains challenging, particularly in low- and middle-income countries.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter study was conducted from October 2019 to September 2020 at four hospitals across Ethiopia's central, southern, and northern regions. Blood cultures from 1,416 patients suspected of sepsis were processed, and isolates were identified using MALDI-TOF. Whole-genome sequencing (WGS) was performed on an Illumina HiSeq 2500, and various bioinformatics tools were used for genome analysis and visualization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 97\n                      <jats:italic>K. pneumonia<\/jats:italic>\n                      e isolates were identified from Tikur Anbessa (\n                      <jats:italic>n<\/jats:italic>\n                      = 37), Yekatit (\n                      <jats:italic>n<\/jats:italic>\n                      = 30), Hawassa (\n                      <jats:italic>n<\/jats:italic>\n                      = 20), and Dessie (\n                      <jats:italic>n<\/jats:italic>\n                      = 10) hospitals. Phylogenetically diverse\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      variants (35 sequence types) were identified, with ST39 (\n                      <jats:italic>n<\/jats:italic>\n                      = 15), ST14 (\n                      <jats:italic>n<\/jats:italic>\n                      = 11), ST391 (\n                      <jats:italic>n<\/jats:italic>\n                      = 10), and ST397 (\n                      <jats:italic>n<\/jats:italic>\n                      = 9) being the most common. Almost all isolates (\n                      <jats:italic>n<\/jats:italic>\n                      = 94) carried ESBL genes, mainly\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>CTX \u2212 M\u221215<\/jats:sub>\n                      , while\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>TEM \u2212 1<\/jats:sub>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      = 75),\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>SHV \u2212 11<\/jats:sub>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      = 43), and\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>OXA \u2212 1<\/jats:sub>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      = 41) were frequently detected, along with other \u03b2-lactamases. Carbapenemase genes included\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>NDM \u2212 1<\/jats:sub>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      = 13),\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>NDM \u2212 5<\/jats:sub>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      = 4), and\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>OXA \u2212 181<\/jats:sub>\n                      (\n                      <jats:italic>n<\/jats:italic>\n                      = 4). Several additional genes were identified that confer resistance to aminoglycosides (\n                      <jats:italic>n<\/jats:italic>\n                      = 70), sulphonamides (\n                      <jats:italic>n<\/jats:italic>\n                      = 70), tetracyclines (\n                      <jats:italic>n<\/jats:italic>\n                      = 64), trimethoprim (\n                      <jats:italic>n<\/jats:italic>\n                      = 54), phenicol (\n                      <jats:italic>n<\/jats:italic>\n                      = 40), quinolones (\n                      <jats:italic>n<\/jats:italic>\n                      = 37), and macrolides (\n                      <jats:italic>n<\/jats:italic>\n                      = 15). Frequent plasmid replicons were Col(pHAD28), Col440I, IncFII(K), IncFIB(K), IncFIB(K)(pCAV1099-114), IncR, and repFIB. Plasmid-borne antimicrobial resistance genes were frequently detected, with IncC exhibiting the broadest spectrum across multiple antibiotic classes.\n                      <jats:italic>Yersiniabactin<\/jats:italic>\n                      subtypes\n                      <jats:italic>ybt4, ybt8, ybt9, ybt10, ybt13, ybt14, ybt15<\/jats:italic>\n                      , and\n                      <jats:italic>ybt16<\/jats:italic>\n                      were identified as virulence genes and were present in 44 of 97\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      strains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      from sepsis patients in Ethiopia showed significant genomic diversity, with widespread ESBL and other plasmid-mediated antimicrobial resistance genes. These findings highlight the urgent need to enhance infection prevention and antimicrobial stewardship nationwide.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1775426","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:36:12Z","timestamp":1777354572000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Genomic characterization of Klebsiella pneumoniae isolates from sepsis patients in Ethiopian tertiary hospitals: a multicenter cross-sectional study"],"prefix":"10.3389","volume":"17","author":[{"given":"Melese Hailu","family":"Legese","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University","place":["Addis Ababa, Ethiopia"]},{"name":"Armauer Hansen Research Institute","place":["Addis Ababa, Ethiopia"]},{"name":"Department of Medical Biochemistry and Microbiology, Biomedical Centre, Uppsala University","place":["Uppsala, Sweden"]},{"name":"Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University","place":["Addis Ababa, Ethiopia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Asrat","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University","place":["Addis Ababa, Ethiopia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dejenie Shiferaw","family":"Teklu","sequence":"additional","affiliation":[{"name":"Ethiopian Public Health Institute","place":["Addis Ababa, Ethiopia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashenafi Alemu","family":"Wami","sequence":"additional","affiliation":[{"name":"Armauer Hansen Research Institute","place":["Addis Ababa, Ethiopia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Badrul","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry and Microbiology, Biomedical Centre, Uppsala University","place":["Uppsala, Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adane","family":"Mihret","sequence":"additional","affiliation":[{"name":"Armauer Hansen Research Institute","place":["Addis Ababa, Ethiopia"]},{"name":"Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University","place":["Addis Ababa, Ethiopia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abraham","family":"Aseffa","sequence":"additional","affiliation":[{"name":"Armauer Hansen Research Institute","place":["Addis Ababa, Ethiopia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00f6te","family":"Swedberg","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry and Microbiology, Biomedical Centre, Uppsala University","place":["Uppsala, Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1038\/s41467-022-28819-2","article-title":"Role of mobile genetic elements in the global dissemination of the carbapenem resistance gene blaNDM","volume":"13","author":"Acman","year":"2022","journal-title":"Nat. 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