Abstract
Carbapenem-resistant (CR) hypervirulent Klebsiella pneumoniae (hvKP) is associated with poor clinical outcome and high death rates. Besides resistance to last-resort antibiotics, CR enterobacteria often exhibit multidrug-resistance phenotypes that greatly reduce the therapeutic options. Moreover, hypervirulent bacteria are highly invasive and spread rapidly. Until the early 2010s, these two phenotypes were not concomitantly observed in the same bacterial cell. Since then, carbapenem resistance and hypervirulence genetic determinants have been co-detected in many K. pneumoniae lineages.4 CR-hvKP were first reported in China, then in the Middle East and Europe and recently in sub-Saharan Africa.Here, we performed a retrospective analysis of whole genome sequencing data of CR-K. pneumoniae (CR-KP) isolates from Djibouti city, Djibouti, East Africa. The objectives of the present studies were to: (i) identify hvKP isolates; (ii) assess how hypervirulence intersects with carbapenem resistance and (iii) evaluate the possibility of their dissemination in the environment. The CR-KP isolates and sequencing data were from a previous One Health-based study on carbapenemase-producing Gram-negative bacilli (CP-GNB) in human (nosocomial and community-acquired infections), livestock, wildlife (fish) and water samples. In this previous study, 32 CP-GNB isolates, including five CR-KP isolates, were identified among the 1650 samples collected.