{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:18:28Z","timestamp":1785417508333,"version":"3.56.0"},"reference-count":49,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Government-funded Project of the Construction of High-level Laboratory","award":["Min201704"],"award-info":[{"award-number":["Min201704"]}]},{"name":"Research Paper Award Matching Fund of Fujian Medical University Union Hospital","award":["0201020"],"award-info":[{"award-number":["0201020"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2025,11,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Salmonella enterica<\/jats:italic>\n                      serovar 1,4,[5],12:i:-\n                            (\n                      <jats:italic toggle=\"yes\">S<\/jats:italic>\n                      .1,4,[5],12:i:-), a monophasic variant of\n                      <jats:italic toggle=\"yes\">Salmonella typhimurium<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">S.\n                        typhimurium<\/jats:italic>\n                      ), is an emerging multidrug-resistant pathogen posing a\n                        significant threat to pediatric health. Research on this variant remains\n                        limited, and due to challenges associated with traditional identification\n                        methods,\n                      <jats:italic toggle=\"yes\">S<\/jats:italic>\n                      .1,4,[5],12:i:- has often been misclassified as\n                      <jats:italic toggle=\"yes\">S. typhimurium<\/jats:italic>\n                      . This study collected clinical data from\n                        122 children infected with\n                      <jats:italic toggle=\"yes\">S<\/jats:italic>\n                      .1,4,[5],12:i:- and 42 with\n                        traditional\n                      <jats:italic toggle=\"yes\">S. typhimurium<\/jats:italic>\n                      in Fujian Province, China,\n                        between 2014 and 2023. Whole-genome sequencing was used for strain analysis.\n                        Our findings revealed that 77.87% of children with\n                      <jats:italic toggle=\"yes\">S<\/jats:italic>\n                      .1,4,[5],12:i:- infection were aged between 1 month and 2\n                        years. Compared with traditional\n                      <jats:italic toggle=\"yes\">S. typhimurium<\/jats:italic>\n                      , children\n                        with\n                      <jats:italic toggle=\"yes\">S<\/jats:italic>\n                      .1,4,[5],12:i:- exhibited milder clinical symptoms,\n                        as evidenced by lower levels of the inflammatory marker C-reactive protein\n                        (16.53 mg\/L\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      . 33.94 mg\/L,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;\n                        0.05) and a lower hospitalization rate (26.23%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      . 42.86%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). These differences may be attributed\n                        to the high carriage rate of the anti-inflammatory gene\n                      <jats:italic toggle=\"yes\">gogB<\/jats:italic>\n                      in\n                      <jats:italic toggle=\"yes\">S<\/jats:italic>\n                      .1,4,[5],12:i:- (95.08%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      . 16.67%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001).\n                        Additionally,\n                      <jats:italic toggle=\"yes\">S<\/jats:italic>\n                      .1,4,[5],12:i:- exhibited a higher\n                        resistance rate to multiple antibiotics, particularly ceftriaxone, than\n                        traditional\n                      <jats:italic toggle=\"yes\">S. typhimurium<\/jats:italic>\n                      (32.79%\n                      <jats:italic toggle=\"yes\">vs<\/jats:italic>\n                      .\n                        7.14%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). This increased resistance may be\n                        associated with the carriage of the IncHI2\/IncHI2A plasmid. The\n                      <jats:italic toggle=\"yes\">S<\/jats:italic>\n                      .1,4,[5],12:i:- ST34 clone prevalent in this region\n                        aligns with the global epidemic trend but exhibits greater genetic\n                        diversity. Overall, the stealthy evolutionary adaptation of low-inflammation\n                        and high-resistance provides novel insights into this variant\u2019s\n                        global dominance. These findings underscore the importance of heightened\n                        clinical awareness and targeted interventions, particularly for vulnerable\n                        pediatric populations.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>\n                        <jats:italic toggle=\"yes\">S<\/jats:italic>\n                        .1,4,[5],12:i:- poses a growing global health threat,\n                            particularly endangering infants and young children. Characterized by\n                            increasing prevalence, multidrug resistance, and diagnostic challenges,\n                            this variant demonstrates milder inflammatory responses yet stronger\n                            antibiotic resistance than traditional\n                        <jats:italic toggle=\"yes\">S. typhimurium<\/jats:italic>\n                        in pediatric infections. Crucially, we identified its unique\n                            \u201clow-inflammation, high-resistance\u201d evolutionary strategy\n                            associated with anti-inflammatory gene\n                        <jats:italic toggle=\"yes\">gogB<\/jats:italic>\n                        and\n                            resistance plasmid IncHI2\/IncHI2A. The stealthy evolutionary adaptation\n                            provides novel insights into this variant\u2019s global dominance,\n                            while offering critical guidance for improving clinical management and\n                            formulating targeted public health measures to protect vulnerable\n                            pediatric populations against this cunning pathogen.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.02235-25","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T14:12:52Z","timestamp":1758809572000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Evolutionary adaptations of a pediatric pathogen: low-inflammatory                    and high-resistance phenotypes in the emerging\n                    <i>Salmonella                        typhimurium<\/i>\n                    monophasic variant 1,4,[5],12:i:-"],"prefix":"10.1128","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6885-1619","authenticated-orcid":true,"given":"Tengfei","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Fuzhou Second General Hospital","place":["Fuzhou, China"]},{"id":[{"id":"https:\/\/ror.org\/055gkcy74","id-type":"ROR","asserted-by":"publisher"}],"name":"Central Laboratory, Fujian Medical University Union Hospital","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huahong","family":"Qiu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/050s6ns64","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaohan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Fuzhou Second General Hospital","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhong","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/050s6ns64","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huifang","family":"Huang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/055gkcy74","id-type":"ROR","asserted-by":"publisher"}],"name":"Central Laboratory, Fujian Medical University Union Hospital","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5783-7253","authenticated-orcid":true,"given":"Huiyu","family":"Chen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/050s6ns64","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, 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