Genomic relatedness of colonizing and invasive disease Klebsiella pneumoniae isolates in South African infants

Sub-Saharan Africa reports the highest rates of neonatal morbidity and mortality worldwide, with Klebsiella pneumoniae (KPn) being a leading infective cause. K. pneumoniae colonizes multiple anatomical sites including the skin, respiratory, and gastrointestinal mucosa . Although the prevalence of KPn colonization varies geographically, data on colonization in African infants is limited, primarily due to challenges in surveillance and diagnostic capabilities. Nevertheless, we recently reported that 59% of hospitalized neonates became colonized by KPn in at least one of the three anatomical sites investigated (skin, rectal, and nasopharynx) during their hospital stay in a microbial surveillance study undertaken in a regional South African hospital. Similarly, findings from Kenya (55%) and Ghana (42%) also report a high prevalence of KPn colonization in neonates hospitalized for more than 3 days most likely due to the high exposure to KPn in the neonatal units of these hospitals.