The association between ambient temperature and antimicrobial resistance of Klebsiella pneumoniae in China: a difference-in-differences analysis

作者：Yingchao Zeng, Weibin Li, Manzhi Zhao, Jia Li, Xu Liu, Lin Shi, Xinyi Yang, Haohai Xia, Shifang Yang, Lianping Yang · 发表于：Frontiers in Public Health · 年份：2023 · DOI：10.3389/fpubh.2023.1158762 · 被引用次数：18 · 研究领域：Pharmaceutical and Antibiotic Environmental Impacts、Antibiotic Use and Resistance、Antibiotic Resistance in Bacteria

Introduction Antimicrobial resistance (AMR) of Klebsiella pneumoniae ( K. pneumoniae ) poses a significant global public health threat and is responsible for a high prevalence of infections and mortality. However, knowledge about how ambient temperature influences the AMR of K. pneumoniae is limited in the context of global warming. Methods AMR data of 31 Chinese provinces was collected from the China Antimicrobial Resistance Surveillance System (CARSS) between 2014 and 2020. Socioeconomic and meteorological data were collected from the China Statistical Yearbook during the same period. A modified difference-in-differences (DID) approach was applied to estimate the association between ambient temperature and third-generation cephalosporin-resistant K. pneumoniae (3GCRKP) and carbapenem-resistant K. pneumoniae (CRKP). Furthermore, moderating effects of socioeconomic factors were also evaluated. Results Every 1°C increase in annual average temperature was associated with a 4.7% (relative risk (RR):1.047, 95% confidence intervals (CI): 1.031–1.082) increase in the detection rate of 3GCRKP, and a 10.7% (RR:1.107, 95% CI: 1.011–1.211) increase in the detection rate of CRKP. The relationships between ambient temperature and 3GCRKP and CRKP were found to be moderated by socioeconomic status (GDP per capita , income per capita , and consumption per capita ; the interaction p -values <0.05), where higher economic status was found to strengthen the effects of temperature on the ...