High diversity of Escherichia coli causing invasive disease in neonates in Malawi poses challenges for O-antigen based vaccine approach.

Chloramphenicol resistance has been observed in other isolates in this setting to decrease, and in line with this we observed 41/195 (21%) isolates resistant to chloramphenicol with a decreasing trend, from 2/7 (28.6%) in 2012 to 3/39 (7.7%) in 2020 (−30.5% change per year; p = 0.000027; Fig. 5d ).

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