Association between particulate matter (PM)2·5 air pollution and clinical antibiotic resistance: a global analysis

作者：Zhenchao Zhou, Xinyi Shuai, Zejun Lin, Xi Yu, Xiaoliang Ba, Mark A. Holmes, Yonghong Xiao, Baojing Gu, Hong Chen · 发表于：The Lancet Planetary Health · 年份：2023 · DOI：10.1016/s2542-5196(23)00135-3 · 被引用次数：117 · 研究领域：Pharmaceutical and Antibiotic Environmental Impacts、Antibiotic Use and Resistance、Indoor Air Quality and Microbial Exposure

Background Antibiotic resistance is an increasing global issue, causing millions of deaths worldwide every year. Particulate matter (PM) 2·5 has diverse elements of antibiotic resistance that increase its spread after inhalation. However, understanding of the contribution of PM 2·5 to global antibiotic resistance is poor. Through univariate and multivariable analysis, we aimed to present the first global estimates of antibiotic resistance and burden of premature deaths attributable to antibiotic resistance resulting from PM 2·5 pollution. Methods For this global analysis, data on multiple potential predictors (ie, air pollution, antibiotic use, sanitation services, economics, health expenditure, population, education, climate, year, and region) were collected in 116 countries from 2000 to 2018 to estimate the effect of PM 2·5 on antibiotic resistance via univariate and multivariable analysis. Data were obtained from ResistanceMap, European Centre for Disease Prevention and Control Surveillance Atlas (antimicrobial-resistance sources), and PLISA Health Information Platform for the Americas. Future global aggregate antibiotic resistance and premature mortality trends derived from PM 2·5 in different scenarios (eg, 50% reduced antibiotic use or PM 2·5 controlled to 5 μg/m 3 ) were projected until 2050. Findings The final dataset included more than 11·5 million tested isolates. Raw antibiotic-resistance data included nine pathogens and 43 types of antibiotic agents. Significant c...