Hao Wang, Li Tang, Haiyang Zhou, Peilu Xie, Min Yue
<p>In October 2024, the World Health Organisation (WHO) designated non-typhoidal serovars of <i>Salmonella enterica</i> as a global high-risk agent for Public Health Emergency of International Concern (PHEIC), spotlighting this urgent threat to global public health.<span><sup>1</sup></span> Unlike non-invasive serovars, which typically cause gastroenteritis, the invasive non-typhoidal <i>Salmonella</i> (iNTS) ones drive severe extraintestinal infections, responsible for approximately 87,100 deaths annually, with mortality rates of 18.1%.<span><sup>3</sup></span> The burden is critically compounded by the escalating crisis of antimicrobial resistance (AMR).</p><p>While historically recognised as a major public health issue in Africa,<span><sup>4</sup></span> often associated with HIV and malaria co-infections,<span><sup>5</sup></span> its epidemiology and transmission dynamics in other regions remain poorly understood. To fill the gap, our group has reported several invasive non-typhodial <i>Salmonella</i> serovars (Goldcoast, Livingstone, Telelkebir and Uzaramo) circulating.<span><sup>6-9</sup></span> Most recently, our large-scale genomic epidemiology study in China,<span><sup>10</sup></span> combining whole-genome sequencing with advanced Bayesian analyses, has uncovered a disturbing evolutionary shift from serovar Choleraesuis to Enteritidis. Challenging the conventional understanding of iNTS as a zoonotic disease transmitted from animals, our genomic evidence, as well as the patient cohort, demonstrates that iNTS is adapting to humans and evolving toward sustained human-to-human transmission.<span><sup>10</sup></span> Growing recognition of the bacterium's pandemic potential demands an urgent revision of global surveillance and targeted interventions.</p><p>Analysing the whole-genome sequencing (WGS) data of iNTS collected over the past three decades in China, the recent study revealed a significant epidemiological shift in China: The predominant serovar has transitioned from <i>S</i>. Choleraesuis, traditionally associated with swine, to <i>S</i>. Enteritidis,<span><sup>10</sup></span> a serovar notorious for its global outbreak-prone and frequent association with poultry.<span><sup>11-13</sup></span> This change indicates possible adaptive evolution driven by environmental changes (e.g. surge of poultry consumption, targeted interventions) or host interactions (e.g. immune pressure). Alarmingly, the genomic analysis<span><sup>10</sup></span> highlights a surge of AMR—86.54% of the iNTS strains possessing quinolone resistance, either through genetic mutations (e.g. <i>gyrA</i> mutations) or acquired genes (e.g. <i>qnr</i> genes). Furthermore, 66% of the isolates were multidrug-resistant (MDR). Of particular concern is the annually increasing detection rate of <i>bla<sub>CTX-M</sub></i> genes, conferring resistance to third-generation cephalosporins. Genetic context and co-localisation analyses implicate mobile genetic elements (MGEs)—plasmid
{"title":"Illuminating the genomic frontier of invasive non-typhoidal Salmonella infections","authors":"Hao Wang, Li Tang, Haiyang Zhou, Peilu Xie, Min Yue","doi":"10.1002/ctm2.70526","DOIUrl":"10.1002/ctm2.70526","url":null,"abstract":"<p>In October 2024, the World Health Organisation (WHO) designated non-typhoidal serovars of <i>Salmonella enterica</i> as a global high-risk agent for Public Health Emergency of International Concern (PHEIC), spotlighting this urgent threat to global public health.<span><sup>1</sup></span> Unlike non-invasive serovars, which typically cause gastroenteritis, the invasive non-typhoidal <i>Salmonella</i> (iNTS) ones drive severe extraintestinal infections, responsible for approximately 87,100 deaths annually, with mortality rates of 18.1%.<span><sup>3</sup></span> The burden is critically compounded by the escalating crisis of antimicrobial resistance (AMR).</p><p>While historically recognised as a major public health issue in Africa,<span><sup>4</sup></span> often associated with HIV and malaria co-infections,<span><sup>5</sup></span> its epidemiology and transmission dynamics in other regions remain poorly understood. To fill the gap, our group has reported several invasive non-typhodial <i>Salmonella</i> serovars (Goldcoast, Livingstone, Telelkebir and Uzaramo) circulating.<span><sup>6-9</sup></span> Most recently, our large-scale genomic epidemiology study in China,<span><sup>10</sup></span> combining whole-genome sequencing with advanced Bayesian analyses, has uncovered a disturbing evolutionary shift from serovar Choleraesuis to Enteritidis. Challenging the conventional understanding of iNTS as a zoonotic disease transmitted from animals, our genomic evidence, as well as the patient cohort, demonstrates that iNTS is adapting to humans and evolving toward sustained human-to-human transmission.<span><sup>10</sup></span> Growing recognition of the bacterium's pandemic potential demands an urgent revision of global surveillance and targeted interventions.</p><p>Analysing the whole-genome sequencing (WGS) data of iNTS collected over the past three decades in China, the recent study revealed a significant epidemiological shift in China: The predominant serovar has transitioned from <i>S</i>. Choleraesuis, traditionally associated with swine, to <i>S</i>. Enteritidis,<span><sup>10</sup></span> a serovar notorious for its global outbreak-prone and frequent association with poultry.<span><sup>11-13</sup></span> This change indicates possible adaptive evolution driven by environmental changes (e.g. surge of poultry consumption, targeted interventions) or host interactions (e.g. immune pressure). Alarmingly, the genomic analysis<span><sup>10</sup></span> highlights a surge of AMR—86.54% of the iNTS strains possessing quinolone resistance, either through genetic mutations (e.g. <i>gyrA</i> mutations) or acquired genes (e.g. <i>qnr</i> genes). Furthermore, 66% of the isolates were multidrug-resistant (MDR). Of particular concern is the annually increasing detection rate of <i>bla<sub>CTX-M</sub></i> genes, conferring resistance to third-generation cephalosporins. Genetic context and co-localisation analyses implicate mobile genetic elements (MGEs)—plasmid","PeriodicalId":10189,"journal":{"name":"Clinical and Translational Medicine","volume":"15 11","pages":""},"PeriodicalIF":6.8,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ctm2.70526","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145502393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}