Bloodstream-associated Salmonella Typhimurium and Enteritidis iNTS pathovariants hyper-replicate in human macrophages

Invasive non-typhoidal Salmonella (iNTS) are a major cause of bloodstream infections in sub-Saharan Africa, yet the host-pathogen interaction mechanisms remain poorly understood. Here, we developed and optimised a human macrophage infection model based on PMA-differentiated THP-1 cells to investigate infection dynamics of clinically relevant Salmonella Typhimurium and Salmonella Enteritidis strains. We compared intracellular survival and replication of gastroenteritis-associated and bloodstream-associated pathovariants, including S. Typhimurium ST313 Lineage 2, the novel S. Typhimurium ST313 Lineage 3 and the understudied S. Enteritidis Central/Eastern African (CEAC) clades. Our results reveal that the CEAC S. Enteritidis and ST313 S. Typhimurium iNTS pathovariants hyper-replicate within host cells, compared to global epidemic isolates. The cellular model achieved robust pro-inflammatory polarisation of human macrophages, while revealing limitations in modelling macrophage plasticity. Overall, this work defines clear differences in intracellular behaviour of Salmonella pathovariants and establishes a robust experimental framework for future studies on invasive disease pathogenesis and therapeutic interventions that target iNTS bacteria.