{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:47:32Z","timestamp":1787168852271,"version":"build-2736575974"},"reference-count":32,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Norwegian Agency for Development Cooperation","award":["QZA 0484 RSA 13\/0010"],"award-info":[{"award-number":["QZA 0484 RSA 13\/0010"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>The global rise in infections caused by multidrug resistant (MDR) Enterobacterales poses a public health problem. We have performed a molecular epidemiological characterisation of representative plasmid-mediated AmpC (pAmpC) and ESBL-positive clinical isolates of Escherichia coli (n = 38) and Klebsiella pneumoniae (n = 17) from a tertiary hospital in Malawi collected in 2017. BlaCTX-M-15 was the most prevalent ESBL-determinant in E. coli (n = 30\/38) and K. pneumoniae (n = 17\/17), whereas blaCMY-2 was detected in nearly all AmpC-phenotype E. coli (n = 15\/17). Whole genome sequencing revealed dominant globally disseminated E. coli sequence types (STs); ST410 (n = 16), ST131 (n = 7), and ST617 (n = 6). The ST distribution in K. pneumoniae was more diverse but included ST101 (n = 2), ST14 (n = 2), and ST340 (n = 2), all considered high-risk MDR clones. The isolates expressed an MDR profile, including resistance against commonly used antibiotics, such as fluoroquinolones, aminoglycosides, and\/or trimethoprim-sulfamethoxazole, and harboured corresponding resistance determinants. Clonal analyses of the major STs of E. coli revealed closely related genetic clusters within ST410, ST131, and ST617 supporting within-hospital transmission between patients and\/or via a common reservoir. The overall findings add to the limited knowledge on the molecular epidemiology of MDR E. coli and K. pneumoniae in Malawi and may help health policy makers to identify areas to target when addressing this major threat of antibiotic resistance.<\/jats:p>","DOI":"10.3390\/tropicalmed7090245","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T01:48:10Z","timestamp":1663206490000},"page":"245","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Molecular Epidemiological Characterisation of ESBL- and Plasmid-Mediated AmpC-Producing Escherichia coli and Klebsiella pneumoniae at Kamuzu Central Hospital, Lilongwe, Malawi"],"prefix":"10.3390","volume":"7","author":[{"given":"Faheema Ebrahim","family":"Choonara","sequence":"first","affiliation":[{"name":"Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4041, South Africa"},{"name":"Microbiology Laboratory, Kamuzu Central Hospital, Lilongwe P.O. Box 149, Malawi"},{"name":"Africa Centre of Excellence in Public Health and Herbal Medicine, College of Medicine, University of Malawi, Private Bag 360, Blantyre 3, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f8rg Christina","family":"Haldorsen","sequence":"additional","affiliation":[{"name":"Norwegian National Advisory Unit on Detection of Antimicrobial Resistance (K-res), Department of Microbiology and Infection Control, University Hospital of North Norway, 9038 Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9991-6315","authenticated-orcid":false,"given":"Jessin","family":"Janice","sequence":"additional","affiliation":[{"name":"Norwegian National Advisory Unit on Detection of Antimicrobial Resistance (K-res), Department of Microbiology and Infection Control, University Hospital of North Norway, 9038 Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Mbanga","sequence":"additional","affiliation":[{"name":"Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4041, South Africa"},{"name":"Department of Applied Biology and Biochemistry, National University of Science and Technology, Corner Cecil & Gwanda Road, Private Bag 939, Bulwayo P.O. Box AC939, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Ndhlovu","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Kamuzu Central Hospital, Lilongwe P.O. Box 149, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osborne","family":"Saulosi","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Kamuzu Central Hospital, Lilongwe P.O. Box 149, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarsizio","family":"Maida","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, Kamuzu Central Hospital, Lilongwe P.O. Box 149, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanuel","family":"Lampiao","sequence":"additional","affiliation":[{"name":"Africa Centre of Excellence in Public Health and Herbal Medicine, College of Medicine, University of Malawi, Private Bag 360, Blantyre 3, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar Skov","family":"Simonsen","sequence":"additional","affiliation":[{"name":"Norwegian National Advisory Unit on Detection of Antimicrobial Resistance (K-res), Department of Microbiology and Infection Control, University Hospital of North Norway, 9038 Troms\u00f8, Norway"},{"name":"Research Group for Host-Microbe Interactions, Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3357-2761","authenticated-orcid":false,"given":"Sabiha Yusuf","family":"Essack","sequence":"additional","affiliation":[{"name":"Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4041, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3728-2270","authenticated-orcid":false,"given":"Arnfinn","family":"Sundsfjord","sequence":"additional","affiliation":[{"name":"Norwegian National Advisory Unit on Detection of Antimicrobial Resistance (K-res), Department of Microbiology and Infection Control, University Hospital of North Norway, 9038 Troms\u00f8, Norway"},{"name":"Research Group for Host-Microbe Interactions, Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Rapid Detection of Extended-Spectrum \u03b2-Lactamases (ESBL) and AmpC \u03b2-Lactamases in Enterobacterales: Development of a Screening Panel Using the MALDI-TOF MS-Based Direct-on-Target Microdroplet Growth Assay","volume":"10","author":"Idelevich","year":"2019","journal-title":"Front. 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