Abstract:
OBJECTIVES: Klebsiella pneumoniae are a frequent cause of nosocomial infections worldwide. Sequence type 147 (ST147)
has been reported as a major circulating high-risk lineage in many countries, and appears to be a formidable platform for
the dissemination of antimicrobial resistance (AMR) determinants. However, the distribution of this pathogen in Western
African hospitals has been scarcely studied. The main objective of this work was to perform whole genome sequencing
of K. pneumoniae isolates from a referral hospital in Kakamega (Kenya) for genotyping and identification of AMR and virulence determinants.
METHODS: In total, 15 K. pneumoniae isolates showing a broad spectrum antimicrobial resistance were selected for whole
genome sequencing by Illumina HiSeq 2500 platform.
RESULTS: ST147 was the dominant lineage among the highly-resistant K. pneumoniae isolates that we sequenced. ST147
was associated with both community- and the hospital-acquired infections, and with different infection sites, whereas
other STs were predominantly uropathogens. Multiple antibiotic resistance and virulence determinants were detected
in the genomes including extended-spectrum β-lactamases (ESBL) and carbapenemases. Many of these genes were
plasmid-borne.
CONCLUSIONS: Our data suggest that the evolutionary success of ST147 may be linked with the acquisition of broad hostrange plasmids, and their propensity to accrue AMR and virulence determinants. Although ST147 is a dominant lineage in
many countries worldwide, it has not been previously reported as prevalent in Africa. Our data suggest an influx of new
nosocomial pathogens with new virulence genes into African hospitals from other continents.
