Genomic Epidemiology of Multidrug-Resistant Escherichia coli and Klebsiella pneumoniae in Kenya, Uganda, and Jordan
Denis K. Byarugaba
, Tamer S. Osman, Omar M. Sayyouh, Godfrey Wokorach, Collins K. Kigen, James W. Muturi, Vanessa N. Onyonyi, Mayar M. Said, Salwa A. Nasrat, Mahmoud Gazo, Bernard Erima, Stephen Alafi, Hope O. Kabatesi, Fred Wabwire-Mangen, Hannah Kibuuka, Anjali P. Sapre, Katelyn V. Bartlett, Francois Lebreton, Melissa J. Martin, Evelyn W. Mahugu, Hunter J. Smith, and Lillian A. Musila
Author affiliation: Makerere University College of Veterinary Medicine, Kampala, Uganda (D.K. Byarugaba); Makerere University Walter Reed Project, Kampala (D.K. Byarugaba, G. Wokorach, B. Erima, S. Alafi, H.O Kabatesi, F. Wabwire-Mangen, H. Kibuuka); US Naval Medical Research Unit EURAFCENT, Cairo, Egypt (T.S. Osman, O.M. Sayyouh, M.M. Said, S.A. Nasrat); Muni University, Arua, Uganda (G. Wokorach); Kenya Medical Research Institute/Walter Reed Army Institute of Research Africa, Nairobi, Kenya (C.K. Kigen, J.W. Muturi, V.N. Onyonyi, L. Musila); Kenya Medical Research Institute, Kisumu City, Kenya (C.K. Kigen, J.W. Muturi, V.N. Onyonyi, L.A. Musila); Ministry of Health, Amman, Jordan (M. Gazo); Makerere University School of Public Health, Kampala (F. Wabwire-Mangen); Walter Reed National Military Medical Center Multidrug-Resistant Organism Repository and Surveillance Network, Silver Spring, Maryland, USA (A.P. Sapre, K.V. Bartlett, F. Lebreton, M.J. Martin); General Dynamics Information Technology, Silver Spring (E.W. Mahugu); US Military Armed Forces Health Surveillance Division, Silver Spring (E.W. Mahugu, H.J. Smith)
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Figure 3
Figure 3. Comprehensive distribution of antimicrobial-resistance genes in 378 Klebsiella pneumoniae isolates from Kenya, Uganda, and Jordan. Antimicrobial-resistance genes associated with nonsusceptibility to various antibiotic classes (polymyxins, third- and fourth-generation cephalosporins, carbapenems, phenicols and quinolones, and aminoglycosides) for each isolate are labeled for presence (red) or absence (white). The presence or absence of gene(s) is mapped onto a neighbor-joining tree curated from its minimum-spanning tree. The most prevalent STs are labeled on the neighbor-joining tree. ESBLs, extended-spectrum β-lactamases; ST, sequence type.
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