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Abstract The plasmid-mediated tigecycline resistance gene tet(X4) threatens the efficacy of tigecycline. While prevalent in Escherichia coli across diverse ecological niches, its evolutionary trajectory in Salmonella remains underappreciated. Here, we conducted nationwide genomic surveillance of 42403 clinical nontyphoidal Salmonella isolates collected from diarrheal patients in China between 2014 and 2025, of which 102 were tet(X4)-positive.
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