Neural manifolds that orchestrate walking and stopping

Walking, stopping and maintaining posture are essential motor behaviors, yet the underlying neural processes remain poorly understood. Here, we investigate neural activity behind locomotion and

Parvalbumin interneurons gate and shape striatal sequences

Loss of striatal interneurons expressing parvalbumin (PV+) is associated with impulsive and uncontrolled behaviors, yet how these cells contribute to striatal information processing is poorly

Sensory processing reformats odor coding around valence and dynamics

Extracting relevant features of a complex sensory signal typically involves sequential processing through multiple brain regions. However, identifying the logic and mechanisms of these transformations

Intrinsic ion dynamics underlies the temporal nature of resting-state functional connectivity

The neural mechanisms underlying the emergence of functional connectivity in resting-state fMRI remain poorly understood. Recent studies suggest that resting-state activity consists of brief periods

Population-level temporal decoding and dynamical structure in frontostriatal circuits during decision making

Perceptual decisions unfold over time, requiring neural circuits to evaluate sensory evidence, track elapsed time, and commit to an action. To investigate how these computations

Using Genomic and Traditional Epidemiologic Approaches to Define Complex Transmission Pathways of Klebsiella pneumoniae Infection in a Neonatal Unit in Botswana, 2022-2023

November 7, 2025

Background: Klebsiella pneumoniae (Kpn) is a major cause of infant mortality worldwide, with most transmission occurring among hospitalized neonates in low- and middle-income countries where infections caused by multidrug-resistant Kpn (MDR-Kpn) are increasingly common. We hypothesized that integrating laboratory surveillance for neonatal colonization and infection, real-time epidemiologic investigations, and whole-genome sequencing (WGS) could identify transmission pathways to guide targeted infection prevention and control (IPC) strategies. Methods and Findings We conducted Kpn surveillance in a 36-bed neonatal unit in Botswana over 12 months (2022-2023). WGS was performed on Kpn isolates from bloodstream infections (BSIs), and MDR-Kpn isolates collected from environmental sampling during outbreaks and twice-monthly colonization screenings (skin and perirectal swabs) using culture media selective for MDR-Kpn (CHROMagar Extended-spectrum beta-lactamase [ESBL]/SuperCarba). WGS data were analyzed using multilocus sequence typing (MLST), pangenome and reference-based single-nucleotide polymorphism (SNP) analyses, and Bayesian phylogenetics. We identified 55 Kpn BSIs during the 12-month surveillance period and the median prevalence of MDR-Kpn colonization was 28%. Kpn was recovered from multi-use intravenous (IV) fluid bags during a Kpn outbreak (41 BSIs, 10 deaths), which was controlled by implementing a 24-hour discard policy for IV medications. Among 270 Kpn isolates available (28 BSI, 232 colonizing, 10 environmental [six IV fluid, four sink drain]), WGS confirmed over half of BSI genomes (n=17) were ST1414, a clone susceptible to third-generation cephalosporins not detected during MDR-Kpn colonization screening, but closely related (<25 SNPs) to six Kpn isolates from contaminated IV fluids. Conclusions This study reinforces the value of integrating WGS with real-time epidemiologic investigations to understand transmission dynamics and guide IPC. Colonization surveillance focused solely on MDR-Kpn may overlook drug-susceptible but outbreak-prone strains.

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