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Genomic epidemiology of clinically critical antibiotic resistance in Salmonella enterica causing bloodstream infections across six Chinese provinces, 1994-2023.

Yanan Wang·Xuebin Xu·Yuhang Pei·Xiaolu Pang·Wufuer Xiayidan·Meilian Huang·Jinhua Meng·Ziru Yang·Yufeng Qiu·Mingliu Wang·Hongxia Yang·Chunmei Jing·Mei Zeng·Sufang Ma·Na Lyu·Yue Liu·Wenqing Wang·Yibin Zhou·Mengqi Qu·Chaochao Zhao·Jiangtao Wang·Baoli Zhu·George F Gao
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Abstract

Clinically critical antibiotic-resistant Salmonella enterica (S. enterica) causing bloodstream infections remains a public health challenge. Here, we aim to reveal the emergence and trends of clinically important antibiotic resistance in S. enterica causing bloodstream infections using 833 isolates from six Chinese provincial-level administrative areas during 1994-2023. We identified 48 serovars and 64 sequence types (STs). Overall, 8.52% of 833 isolates were resistant or had decreased susceptibility to ciprofloxacin, 4.32% and 6.84% reported resistance or decreased susceptibility to third- and fourth-generation cephalosporins (3GCs and 4GCs), 1.80% reported resistance to fosfomycin, and 2.16% reported resistance to azithromycin. Across these six regions, azithromycin and fosfomycin resistance is increasing, as is decreased susceptibility or resistance to ciprofloxacin, 3GCs, and 4GCs, especially among younger children and elderly people. Clinically prioritized antibiotic resistance also varies by region, serovar, and age group. S. Paratyphi A genotype 2.3.3 strains are mainly divided into 2 lineages distributed in Guangxi and Shanghai. Within the scope of this passive surveillance dataset, S. Typhi genotype 4.3.1.2.1 was identified as the earliest documented case among the collected isolates. Our retrospective and longitudinal genomic epidemiology study provides critical data for the formulation of treatment guidelines and policies for bloodstream infections and for the monitoring and control of antimicrobial resistance.

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HumansChinaAnti-Bacterial AgentsSalmonella entericaSalmonella InfectionsMicrobial Sensitivity TestsGenotypeMolecular EpidemiologyDrug Resistance, BacterialThird Generation CephalosporinsBacteremiaRetrospective StudiesChildChild, PreschoolDrug Resistance, Multiple, BacterialGenomicsAdultCiprofloxacinSerogroupAzithromycinAgedAntibiotic resistance geneBacterial genomicsBloodstream infectionPriority antibiotic resistanceJournal Article

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Yanan Wang, Xuebin Xu, Yuhang Pei, Xiaolu Pang, Wufuer Xiayidan, Meilian Huang, Jinhua Meng, Ziru Yang, Yufeng Qiu, Mingliu Wang, Hongxia Yang, Chunmei Jing, Mei Zeng, Sufang Ma, Na Lyu, Yue Liu, Wenqing Wang, Yibin Zhou, Mengqi Qu, Chaochao Zhao, Jiangtao Wang, Baoli Zhu, George F Gao. 2026-08-18. Genomic epidemiology of clinically critical antibiotic resistance in Salmonella enterica causing bloodstream infections across six Chinese provinces, 1994-2023.. https://doi.org/10.1016/j.micres.2026.128691

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Journal Article resourceAdult subjectAged subjectAnti-Bacterial Agents subjectBacteremia subjectChild subjectChild, Preschool subjectChina subjectDrug Resistance, Bacterial subjectDrug Resistance, Multiple, Bacterial subjectGenomics subjectGenotype subjectHumans subjectJournal Article subjectMicrobial Sensitivity Tests subjectbloodstream infection subject

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