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Background  Epidemiological data of cephalosporin-resistant  Enterobacterales  in Sub-Saharan Africa is still restricted, and in particular in Mozambique. The aim of this study was to detect and characterize extended-spectrum β-lactamase (ESBL) - and plasmid-mediated AmpC (pAmpC)-producing clinical strains of  Escherichia coli  at Maputo Central Hospital (MCH), a 1000-bed reference hospital in Maputo, Mozambique.    Methods  A total of 230 clinical isolates of  E. coli  from urine ( n  = 199) and blood cultures ( n  = 31) were collected at MCH during August–November 2015. Antimicrobial susceptibility testing was performed by the disc diffusion method and interpreted according to EUCAST guidelines. Isolates with reduced susceptibility to 3rd generation cephalosporins were examined further; phenotypically for an ESBL−/AmpC-phenotype by combined disc methods and genetically for ESBL- and pAmpC-encoding genes by PCR and partial amplicon sequencing as well as genetic relatedness by ERIC-PCR.    Results  A total of 75 isolates with reduced susceptibility to cefotaxime and/or ceftazidime ( n  = 75) from urine ( n  = 58/199; 29%) and blood ( n  = 17/31; 55%) were detected. All 75 isolates were phenotypically ESBL-positive and 25/75 (33%) of those also expressed an AmpC-phenotype. ESBL-PCR and amplicon sequencing revealed a majority of  bla  CTX-M  ( n  = 58/75; 77%) dominated by  bla  CTX-M-15 . All AmpC-phenotype positive isolates ( n  = 25/75; 33%) scored positive for one or more pAmpC-genes dominated by  bla  MOX/FOX . Multidrug resistance (resistance ≥ three antibiotic classes) was observed in all the 75 ESBL-positive isolates dominated by resistance to trimethoprim-sulfamethoxazole, ciprofloxacin and gentamicin. ERIC-PCR revealed genetic diversity among strains with minor clusters indicating intra-hospital spread.    Conclusion  We have observed a high prevalence of MDR pAmpC- and/or ESBL-producing clinical  E. coli  isolates with FOX/MOX and CTX-Ms as the major β-lactamase types, respectively. ERIC-PCR analyses revealed genetic diversity and some clusters indicating within-hospital spread. The overall findings strongly support the urgent need for accurate and rapid diagnostic services to guide antibiotic treatment and improved infection control measures.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12879-020-05696-y.

bmc infectious diseases

High prevalence of multidrug resistant ESBL- and plasmid mediated AmpC-producing clinical isolates of Escherichia coli at Maputo Central Hospital, Mozambique