The total 785 E. coli isolates represented 124 sequence types (STs), of which 20 (16.1 percent) were shared between the three countries. The dominant E. coli ST was ST131 in all three countries, which has emerged globally as a major cause of MDR infections. Additionally, three E. coli STs were identified as pathogenic and present in food-producing animals.

Similarly, genetic diversity of K. pneumoniae was high. There were 123 distinct STs, and only 11 (8.9 percent) STs were shared across the three countries; four STs were considered high-risk by the researchers.

Regarding the AMR profiles of the pathogens, extended-spectrum beta-lactamase (ESBL) genes were identified through WGS in 50.8 percent of E. coli isolates and 68.8 percent of K. pneumoniae isolates. Additionally, two E. coli isolates and five K. pneumoniae isolates showed mobile colistin resistance, and carbapenemase genes were detected in 1 percent and 12 percent of E. coli and K. pneumoniae isolates, respectively.

The researchers underscore that the increasing spread of high-risk clones of E. coli and K. pneumoniae constitutes a serious threat for managing infections. The increased resistance to critical antimicrobial drugs like carbapenems and third- and fourth-generation cephalosporins is concerning, and the increase in mobile genetic elements that spread resistance further enhances the threat to public health. The abundance of global high-risk STs bearing resistance genes indicates their effective dissemination, the potential for intraspecies and interspecies transmission of resistance genes, and the emergence of new high-risk clones.