Climate change and antimicrobial resistance in the Western Pacific: a mixed-methods systematic analysis

作者：Lianping Yang, Zhiwei Ma, Fanqian Meng, Ruonan Wang, Shanquan Chen, Chaojie Liu, Hung Chak Ho, Meng Xu, Alvin Qijia Chua, Li Yang Hsu, Yanhui Jia, Yongqiang Zhang, Cunrui Huang, John S. Ji · 发表于：The Lancet Regional Health - Western Pacific · 年份：2025 · DOI：10.1016/j.lanwpc.2025.101772 · 被引用次数：2 · 研究领域：Climate Change and Health Impacts、Zoonotic diseases and public health、Antibiotic Use and Resistance

Background Climate change and antimicrobial resistance (AMR) are escalating public health threats globally. The Western Pacific Region faces unique climatic and socioeconomic vulnerabilities, but evidence on this climate-AMR intersection is limited. We aimed to systematically provide evidence on this critical issue. Methods We conducted a three-stage mixed-methods systematic analysis: (1) a narrative review mapping the regional AMR landscape and summarizing potential climate-driven mechanisms; (2) a systematic review (PubMed and Google Scholar, January 2000–March 2025) of regional quantitative studies; and (3) an empirical quantitative analysis using a longitudinal panel dataset. This analysis completes our systematic approach by visualizing AMR mortality trends (using data from the GRAM project) and applying regression analysis to model AMR-attributable death rates based on climatic and socioeconomic factors, providing quantitative evidence of the regional situation and its potential drivers. Findings Literature review evidence showed that increasing temperature caused by climate change directly accelerates bacterial growth and resistance mutation rates and indirectly affects healthcare disruptions and antibiotic misuse during extreme weather events. We included 18 quantitative studies synthesised using the SWiM framework, which provided more specific evidence that higher temperatures are associated with increased clinical resistance rates and enhanced environmental dissemin...