Evidence map›Paper›PMID 42226118›Full record

ArticleBMC microbiology2026

Genomic architecture of fourth-generation cephalosporin-resistant Klebsiella pneumoniae Species Complex (KpSC) from patients and their hospital environment in Uganda.

Denis K Byarugaba, Godfrey Wokorach, Yaovi M H Hounmanou, Agnes Wanyana, Stephen Alafi, Fred Wabwire-Mangen, Henrik Christensen, John E Olsen

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Article in BMC microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Denis K ByarugabaCollege of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda. denis.byarugaba@mak.ac.ug.
Godfrey WokorachMakerere University Walter Reed Program, P.O. Box 16542, Kampala, Uganda.
Yaovi M H HounmanouDepartment of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
Agnes WanyanaMakerere University Walter Reed Program, P.O. Box 16542, Kampala, Uganda.
Stephen AlafiMakerere University Walter Reed Program, P.O. Box 16542, Kampala, Uganda.
Fred Wabwire-MangenMakerere University Walter Reed Program, P.O. Box 16542, Kampala, Uganda.
Henrik ChristensenDepartment of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
John E OlsenDepartment of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The emergence of fourth-generation cephalosporin-resistant (4GCR) K. pneumoniae species complex (KpSC) is a human health concern due to limited therapeutic options and association of the bacteria with severe morbidity and mortality. This study investigated the genomic characteristics of 4GCR K. pneumoniae species complex strains from patients and their hospital environment in Uganda. Twenty-seven isolates were obtained from two tertiary healthcare hospitals in Uganda. Whole genomic sequence (WGS) analysis revealed dominance of phylogroup Kp1 (70.4%). Isolates were highly diverse genetically, representing 15 clonal groups and 10 different serotypes, with isolates of CG17 (6/27) and serotype O5 (25%) as the most common. Core genome SNP-based phylogenetic comparison placed Ugandan strains together with strains from African lineages; however, with a few strains clustering with global references. Most strains carried multiple resistance genes, particularly CTX-M-15 (24/27) and aminoglycoside-modifying enzymes. A search for virulence factors revealed that most isolates carried few virulence genes, particularly those associated with hypervirulence. A yersiniabactin loci was detected in a subset of Kp1 isolates. Ten plasmid replicons and multiple insertion sequences were detected that may mediate resistance dissemination. These findings provide evidence of 4GCR KpSC in clinical settings and patient environments in Uganda. This underscores the need for ongoing genomic surveillance and antimicrobial stewardship to enable early detection of resistant strains and prevent localized clusters from escalating into widespread outbreaks in hospitals across the country.

Indexed as

Anti-Bacterial AgentsCephalosporinsKlebsiella InfectionsKlebsiella pneumoniaeDrug Resistance, Multiple, BacterialGenome, BacterialHospitalsHumansMicrobial Sensitivity TestsPhylogenyPlasmidsUgandaVirulence FactorsWhole Genome SequencingAnti-Bacterial AgentsCephalosporinsVirulence FactorsAntimicrobial-resistantAntimicrobial surveillanceCarbapenem-resistantEnterobacteriaceae

Identifiers

PMID42226118
PMCPMC13435522

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.