
Salmonella enterica serovar Paratyphi A is a significant but under-characterised cause of enteric fever in South Asia. In Pakistan, where the typhoid conjugate vaccine has been introduced to combat S . Typhi, S . Paratyphi A remains a prominent cause of bacteraemia, raising concerns about shifts in disease burden and antimicrobial resistance (AMR). Here, we provide a comprehensive genomic and phylogenetic analysis of 354 S . Paratyphi A isolates collected from three provinces in Pakistan between 2017 and early 2022. Whole-genome sequencing revealed the dominance of genotypes 2.3.3 and 2.4.5, indicating a largely stable population structure over time, and the presence of widespread fluoroquinolone-associated gyrA mutations. Although multidrug resistance was not detected, we identified one isolate harbouring an acrB -R717Q mutation associated with azithromycin resistance. Plasmid and replicon analysis revealed low prevalence of extrachromosomal elements, including cryptic plasmids with unknown function. Phylogenetic placement of these isolates in a global context demonstrated close relatedness to contemporary South Asian organisms. Our findings establish a genomic baseline for S . Paratyphi A in Pakistan, essential for future surveillance, AMR monitoring, and evaluating the potential impact of forthcoming paratyphoid vaccines.
Whole Genome Sequencing, Genotype, enteric fever, Microbial Sensitivity Tests, Anti-Bacterial Agents, phylogenetics, Salmonella paratyphi A, Drug Resistance, Multiple, Bacterial, Paratyphoid Fever, Humans, Pakistan, Salmonella Paratyphi A, Phylogeny, Genome, Bacterial, Plasmids
Whole Genome Sequencing, Genotype, enteric fever, Microbial Sensitivity Tests, Anti-Bacterial Agents, phylogenetics, Salmonella paratyphi A, Drug Resistance, Multiple, Bacterial, Paratyphoid Fever, Humans, Pakistan, Salmonella Paratyphi A, Phylogeny, Genome, Bacterial, Plasmids
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