Globally,
antibiotic-resistant Klebsiella spp. cause
healthcare-associated infections with high mortality rates, and the rise of hypervirulent Klebsiella pneumoniae (hvKp) poses a significant threat to human health linked to
community-acquired infections and increasing non-susceptibility. We investigated the phenotypic and genetic features of 36 Klebsiella isolates recovered from invasive
infections at Hospital Central of Maputo in Mozambique during one year. The majority of the isolates displayed multidrug resistance (MDR) (29/36) to
cephalosporins,
gentamicin,
ciprofloxacin, and
trimethoprim-sulfamethoxazole but retained susceptibility to
amikacin,
carbapenems, and
colistin. Most isolates were ESBLs-producing (28/36), predominantly carrying the blaCTX-M-15 and other
beta-lactamase genes (blaSHV, blaTEM-1, and blaOXA-1). Among the 16 genomes sequenced, multiple resistance genes from different
antibiotic classes were identified, with blaCTX-M-15, mostly in the ISEcp1-blaCTX-M-15-orf477 genetic environment, co-existing with blaTEM-1 and aac(3)-IIa in five isolates. Our results highlight the presence of polyclonal MDR ESBL-producing K. pneumoniae from eight sequence types (ST), mostly harbouring distinct
yersiniabactin within the conjugative integrative
element (
ICE). Further, we identified susceptible hvKp ST23, O1-K1-type isolates carrying
yersiniabactin (ybt1/ICEKp10),
colibactin,
salmochelin,
aerobactin, and hypermucoid locus (rmpADC), associated with severe
infections in humans. These findings are worrying and underline the importance of implementing surveillance strategies to avoid the risk of the emergence of the most threatening MDR hvKp.