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Cronobacter sakazakii is an opportunistic foodborne pathogen known to cause severe neonatal infections. However, its subclinical effects on human health remain largely unexplored. Here, we report that intestinal colonization by Cronobacter is potentially correlated with human neurobehavioral alterations in the absence of bacterial translocation across host barriers. Analysis of fecal microbiota from the children in GUSTO cohort revealed that Cronobacter abundance was significantly and positively correlated with their emotional reactivity and affective problem scores, suggesting an association between gut Cronobacter colonization and emotional dysfunction. Using a zebrafish larvae model, we demonstrated that enteric colonization by C. sakazakii ATCC 25944 triggered a distinctive bending phenotype and locomotor instability, indicative of central nervous system (CNS) disturbance. Multi-omics profiling revealed upregulation of genes related to circadian rhythm (e.g., per2, nr1d1, nr1d2) and neuropsychiatric markers (hint1), alongside metabolic dysregulation involving lipid classes linked to neurodegenerative stress. Random mutagenesis coupled with whole-genome sequencing identified modifier variants in genes associated with lipopolysaccharide (LPS) biosynthesis and fimbrial adhesion, which attenuated the neurotoxic phenotype. LPS isolated from wild-type C. sakazakii, but not from mutants, reproduced the CNS impairment phenotype, highlighting its crucial virulence role. Collectively, our findings provide the first evidence that enteric Cronobacter colonization may affect human emotional development via gut-derived LPS signaling, emphasizing its underestimated role in the gut–brain axis and neurobehavioral health.
Toh et al. (Thu,) studied this question.