Decentralized nanopore genomics reveals diverse <i>Klebsiella pneumoniae</i> and no evidence of patient-patient transmission in a New Zealand hospital

<i>Klebsiella pneumoniae</i> is a leading cause of healthcare-associated infections worldwide, yet its population structure and transmission dynamics remain largely uncharacterized in New Zealand hospitals. We conducted a 15-month prospective genomic surveillance pilot at Wellington Regional Hospital, embedding Oxford Nanopore MinION sequencing directly within the diagnostic laboratory. Clinical and screening isolates (<i>n</i>=157) underwent on-site sequencing and genotyping. Following quality control, 121 (77%) high-quality genomes (118 complete assemblies) were analysed for diversity, antimicrobial resistance (AMR), virulence loci and plasmid content and assessed for evidence of in-hospital transmission. The cohort covered many ages (0 to 95 years), with nearly half of the patients aged ≥65 years. The local <i>K. pneumoniae</i> population was highly diverse, comprising 75 distinct sequence types (STs), of which 68% were single-isolate STs. Although a few lineages recurred intermittently (e.g. ST253 and ST17), no clone showed evidence of patient-patient transmission. Plasmid reconstructions showed backbones dominated by F-type, Col, and mosaic multi-replicon elements. Acquired AMR genes were plasmid-borne in 35/118 complete genomes. Chromosomes mostly carried intrinsic determinants typical of <i>K. pneumoniae</i>: <i>bla</i> _SHV (intrinsic ampicillin resistance) and <i>fos</i>A and <i>oqx</i>AB (which may raise minimum inhibitory concentrations but, in their intrinsic forms, do not exceed clinical breakpoints). Few isolates carried markers of <i>K. pneumoniae</i> virulence plasmids (<i>iuc</i>/<i>iro</i> siderophores and <i>rmp</i>A/<i>rmp</i>A2; Kleborate virulence score ≥3), and none showed convergence of virulence and acquired AMR. This study shows that prospective, hospital-based nanopore sequencing is feasible in routine diagnostic settings and can deliver high-resolution genomic intelligence for infection prevention and control. In this setting, <i>K. pneumoniae</i> isolates arose from a genotypically heterogeneous background without evidence of patient-patient transmission. This pilot establishes a genomic baseline for <i>K. pneumoniae</i> in a major New Zealand hospital and supports a trigger-based framework for early detection of high-risk clones before they become established.