Thye Thorsten, Krumkamp Ralf, Lusingu John P A, Ofori Linda Aurelia, Minja Daniel T R, Flieger Antje, Gesase Samwel, Phillips Richard, Simon Sandra, Obiri-Danso Kwasi, Akenten Charity Wiafe, Mbwana Joyce, Paintsil Ellis, Ascofare Oumou Maiga, Jaeger Anna, Lamshöft Maike, Eibach Daniel, Loag Wibke, Berg Stefan, May Jürgen, Dekker Denise
Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nochtstr. 74, 20359, Hamburg, Germany.
German Centre for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems, Inhoffenstr.7, Brunswick, 338124, Germany.
Antimicrob Resist Infect Control. 2025 May 13;14(1):46. doi: 10.1186/s13756-025-01561-2.
In sub-Saharan Africa, invasive non-typhoidal Salmonella disease, characterized by bloodstream infections with high mortality rates, poses a significant public health burden. In Africa, Salmonella enterica, which are typically livestock- associated pathogens in industrialised countries, have genetically evolved and anthroponotic transmission has been proposed for S. Typhimurium ST313. In this study, we investigated the hypothesis of an exclusively anthroponotic transmission reservoir of Salmonella enterica ST313 and aimed to identify reservoirs for other Salmonella spp., shedding light on their occurrence in different ecological niches.
This study used a One Health approach and Salmonella were isolated from humans, livestock and the environment, in Tanzania and in Ghana. Salmonella spp. were identified by biochemical methods and antibiotic susceptibility was tested. Isolates were subjected to whole genome sequencing.
Out of 9,086 collected samples, 222 Salmonella enterica were identified comprising 58 serovars. The highest level of antimicrobial resistance was found in humans with emerging fluroquinolone resistance and multidrug resistance being highest in isolates from blood cultures (24%, n/N = 11/46). For the invasive strains, the sequence types S. Typhimurium ST313 and ST19 were most common and ST313 was associated with multidrug resistance, followed by S. Enteritidis ST11 and ST147 and S. Dublin ST10. An overlap of sequence types amongst human-livestock and human-environmental strains was detected for S. Typhimurium ST19 but not found for ST313 and the two serovars Dublin and Enteritidis.
Our study adds further evidence of S. Typhimurium ST313 being restricted to a human reservoir and linked to multidrug resistance. Additionally, our study provides comprehensive insights into Salmonella genetic diversity and distribution among humans, animals and the environment in Ghana and in Tanzania. This sheds light on other potential reservoirs for infections, all of which show antimicrobial resistance. Further research into stool carriage is warranted, encompassing patients with invasive disease and those with and without diarrhoea, to identify transmission reservoirs in particular for invasive disease-causing strains. These findings underscore the need for integrated One Health approaches to effectively monitor and manage salmonellosis and mitigate public health risks. Continued research into the spread of Salmonella spp. and its evolution is crucial for targeted interventions and disease control.
在撒哈拉以南非洲地区，侵袭性非伤寒沙门氏菌病以血流感染且死亡率高为特征，构成了重大的公共卫生负担。在非洲，肠炎沙门氏菌在工业化国家通常是与牲畜相关的病原体，其基因已发生进化，有人提出鼠伤寒沙门氏菌ST313存在人传人现象。在本研究中，我们调查了肠炎沙门氏菌ST313仅通过人传人传播的假设，并旨在确定其他沙门氏菌属的宿主，以了解它们在不同生态位中的出现情况。
本研究采用“同一健康”方法，在坦桑尼亚和加纳从人类、牲畜和环境中分离沙门氏菌。通过生化方法鉴定沙门氏菌属，并测试抗生素敏感性。对分离株进行全基因组测序。
在收集的9086份样本中，鉴定出222株肠炎沙门氏菌，包括58个血清型。在人类中发现的抗菌药物耐药性水平最高，新出现的氟喹诺酮耐药性和多重耐药性在血培养分离株中最高（24%，n/N = 11/46）。对于侵袭性菌株，鼠伤寒沙门氏菌ST313和ST19序列型最为常见，ST313与多重耐药性相关，其次是肠炎沙门氏菌ST11和ST147以及都柏林沙门氏菌ST10。检测到鼠伤寒沙门氏菌ST19在人 - 牲畜和人 - 环境菌株之间存在序列型重叠，但ST313以及都柏林和肠炎这两个血清型未发现这种重叠。
我们的研究进一步证明了鼠伤寒沙门氏菌ST313局限于人类宿主并与多重耐药性有关。此外，我们的研究全面深入地了解了加纳和坦桑尼亚人类、动物和环境中沙门氏菌的遗传多样性和分布情况。这揭示了其他潜在的感染宿主，所有这些宿主都表现出抗菌药物耐药性。有必要对粪便携带情况进行进一步研究，涵盖侵袭性疾病患者以及有腹泻和无腹泻的患者，以确定特别是侵袭性致病菌株的传播宿主。这些发现强调了需要采用综合的“同一健康”方法来有效监测和管理沙门氏菌病并降低公共卫生风险。持续研究沙门氏菌属的传播及其进化对于有针对性的干预措施和疾病控制至关重要。
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