Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Epidemiology of Nontyphoidal Salmonella Infections in Korean Children and Genetic Factors Associated with Extra-intestinal Invasion: A Whole-genome Sequencing Analysis

  • Hyun Mi Kang (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Jiyon Chu (Department of Medical Sciences, Graduate School of The Catholic University of Korea) ;
  • In Hyuk Yoo (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • In Young Yoo (Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jeong-Ih Shin (Department of Medical Sciences, Graduate School of The Catholic University of Korea) ;
  • Mi-Ran Seo (ConnectaGen) ;
  • Yeun-Jun Chung (Department of Medical Sciences, Graduate School of The Catholic University of Korea) ;
  • Seung-Hyun Jung (Department of Medical Sciences, Graduate School of The Catholic University of Korea) ;
  • Yeon Joon Park (Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2024.07.18
  • Accepted : 2025.03.04
  • Published : 2025.05.01
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Abstract

Background: Understanding the virulence and pathogenicity of invasive nontyphoidal Salmonella (iNTS) in children may support timely treatment and enable closer monitoring of chronic infections. iNTS epidemiology in Asia remains inadequately described. We analyzed the genetic diversity and virulence genes associated with extra-intestinal invasion in Korean children. Methods: Salmonella isolates from children <18 yrs of age diagnosed with moderate-to-severe salmonellosis between January 2019 and December 2021 were subjected to antibiotic susceptibility testing and whole-genome sequencing. Results: In total, 58 cases were included. We identified 20 serotypes, the most prevalent being Salmonella Enteritidis (N=21), followed by Infantis (N=6), I 4,[5],12:i:- (N=5), and Bareilly (N=5). Extra-intestinal invasion occurred in 12 (20.7%) cases involving Salmonella Oranienburg (2/2), Give (1/1), Javiana (1/1), Paratyphi B var. L(+) tartrate+ (1/1), Schwarzengrund (1/1), Singapore (1/1), Montevideo (1/2), Saintpaul (1/2), I 4:b:- (1/2), Infantis (1/6), and Enteritidis (1/21). While the numbers of total virulence genes and genes belonging to major virulence categories did not significantly differ between iNTS and non-iNTS, several genetic factors, including Salmonella pathogenicity island (SPI)-1 (P=0.039), SPI-2 (P=0.020), SPI-5 (P=0.014), SPI-13 (P=0.010), cytolethal distending toxin-related genes (P=1.4×10-4), fepC (P=0.021), and tcpC (P=0.040) were more frequent in invasive isolates. Conclusions: Salmonella Enteritidis-ST11 predominated in infections among Korean children, but invasive isolates were rare. Early detection of genetic factors associated with extra-intestinal invasion will be helpful for prompt and appropriate treatment.

Keywords

Acknowledgement

We appreciate the support of the Basic Medical Science Facilitation Program through the Catholic Medical Center of the Catholic University of Korea, funded by the Catholic Education Foundation and Korea Research Environment Open NETwork (KRE-ONET), which is managed and operated by the Korea Institute of Science and Technology Information (KISTI).

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