Genomic Evidence for Extra-Intestinal Foodborne Disease due to Zoonotic Bacteria: A Public Health Risk

Foodborne diseases (FBD) constitute a significant worldwide concern with both health and socioeconomic repercussions. FBD predominantly manifest with gastrointestinal symptoms. Nevertheless, extraintestinal infections and symptoms caused by foodborne pathogens are increasingly being reported worldwide. Furthermore, FBD caused by drug resistant bacteria causing both intestinal and extra-intestinal FBD (EIFBD) has further exacerbated their burden. This review (i) summarizes the status of intestinal foodborne pathogens, (ii) delineates the drivers, highlights the (iii) genomic evidence, and (iv) global significance of EIFBD. Understanding the transmission routes and genomic evolution of the principal bacteria causing extra-intestinal FBD is of paramount importance to fully assess the burden of FBD globally, especially in under-resourced regions of Asia, Africa, and Latin America. Acknowledging EIFBD as an integral part of FBD is critical to reach sustainable development. Integrated strategies considering the One Health approach are requisite if FBD are to be controlled, plus to ensure food safety and security. Data summaryThe authors confirm that all supporting data, code and protocols have been provided within the article or through supplementary data files. Impact StatementFoodborne diseases (FBD) present a global health challenge, with the significant health impact and economic costs. Commonly, these illnesses manifest as gastrointestinal troubles; however, there is an alarming increase in reports of foodborne pathogens causing infections beyond the intestinal tract. The complexity of managing FBD is worsened as various pathogens exhibit resistance to antibiotics, a concern applicable to both intestinal and extraintestinal infections. This review serves several critical functions: (i) provide a current overview of the pathogens responsible for gastrointestinal FBD, (ii) examine the underlying factors contributing to the proliferation of these diseases, (iii) present insights gleaned from genomic studies, which enhance our understanding of these pathogens. Grasping the mechanisms of pathogen transmission and genetic evolution is essential to accurately evaluate the worldwide impact of FBD. Acknowledging extraintestinal infections as a significant component of FBD is vital for sustainable progress. Combating FBD effectively necessitates a comprehensive "One Health" approach, which integrates the well-being of humans, animals, and the environment. Such a strategy is imperative not only for controlling FBD but also for ensuring the safety and availability of food resources globally.