Jennifer CornickPatrick MusichaChikondi PenoEzgi SeagerPui Ying Iroh TamSithembile BilimaAisleen BennettNeil KennedyNicholas FeaseyEva HeinzAmy K. CainMalawi-Liverpool-Wellcome Trust Clinical Research ProgrammeUniversity of Malawi College of MedicineQueen's University BelfastSt George’s, University of LondonHeartlands HospitalLiverpool School of Tropical MedicineUniversity of LiverpoolMacquarie UniversityMahidol UniversityUniversity of Edinburgh, College of Medicine and Veterinary MedicineNuffield Department of MedicineWellcome Sanger Institute2022-08-042022-08-042021-01-01Microbial Genomics. Vol.7, No.11 (2021)205758582-s2.0-85121993914https://repository.li.mahidol.ac.th/handle/20.500.14594/76317A special-care neonatal unit from a large public hospital in Malawi was noted as having more frequent, difficult-to-treat infec-tions, and a suspected outbreak of multi-drug-resistant Klebsiella pneumoniae was investigated using genomic characterisa-tion. All K. pneumoniae bloodstream infections (BSIs) from patients in the neonatal ward (n=62), and a subset of K. pneumoniae BSI isolates (n=38) from other paediatric wards in the hospital, collected over a 4 year period were studied. After whole genome sequencing, the strain sequence types (STs), plasmid types, virulence and resistance genes were identified. One ST340 clone, part of clonal complex 258 (CC258) and an ST that drives hospital outbreaks worldwide, harbouring numerous resistance genes and plasmids, was implicated as the likely cause of the outbreak. This study contributes molecular information necessary for tracking and characterizing this important hospital pathogen in sub-Saharan Africa.Mahidol UniversityBiochemistry, Genetics and Molecular BiologyImmunology and MicrobiologyMedicineArticleSCOPUS10.1099/mgen.0.000703