Editorial: Transmission dynamics and population genomics of superbug pathogens of public health importance
Résumé
Antimicrobial-resistant and high-risk bacterial pathogens are shaped by processes operating across multiple biological and epidemiological scales: genetic variation within pathogen populations, acquisition and dissemination of resistance determinants, transmission within healthcare and community settings, and interactions with susceptible hosts (Sati et al., 2025).Understanding any one of these dimensions in isolation provides only a partial view of why particular pathogens emerge, persist, spread, or cause disproportionate clinical and publichealth burdens (GBD 2021Antimicrobial Resistance Collaborators, 2024). This Research Topic was conceived to bring these levels together, with particular emphasis on transmission dynamics and population genomics. Its 16 contributions span genomic epidemiology, antimicrobial resistance, outbreak investigation, clinical epidemiology, host-pathogen interactions, and surveillance across healthcare, population, and community settings.Collectively, they can be considered through four complementary themes.Population genomics provides a framework for distinguishing successful lineages, tracking their geographical persistence, and identifying genetic traits that may contribute to adaptation, Together, these studies illustrate a common principle: antimicrobial resistance and pathogenic potential are properties of evolving pathogen populations rather than static species labels.Population genomics is therefore most informative when it captures lineage replacement, resistance acquisition, virulence-associated traits, and geographical structure through time.The public-health importance of resistance depends not only on its emergence but also on its Acinetobacter baumannii-positive events among 460,620 patients. Of the positive cases, about 46% occurred in ICU patients, while older age, male sex, and seasonal patterns were associated with positivity. Such data are useful for identifying groups and settings with a higher observed burden, although their retrospective design does not by itself establish causal drivers of infection. These findings identify public transport as a potential community interface for exposure to resistant bacteria, but environmental detection should not be equated with demonstrated person-to-person transmission. Taken together, these studies show that surveillance is most informative when microbiological and genomic data are interpreted alongside time, place, population, and exposure context.Collectively, the studies in this Research Topic show that the public-health impact of antimicrobial-resistant and high-risk bacterial pathogens emerges from interconnected processes spanning pathogen evolution, resistance acquisition, transmission, host susceptibility, and surveillance context. Whole-genome sequencing has increased the resolution with which lineages, resistance determinants, and suspected transmission events can be investigated, but genomic data are most informative when integrated with clinical, epidemiological, and environmental evidence. Strengthening longitudinal and genomic surveillance across healthcare and community settings, while linking molecular findings to patient outcomes and exposure networks, will be important for detecting emerging high-risk lineages and translating pathogen genomics into effective infection-prevention and antimicrobial-stewardship strategies.
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