Poverty and prevalence of antimicrobial resistance in invasive isolates

Area of Science:

• Global Health
• Infectious Diseases
• Microbiology

Background:

• Antimicrobial resistance (AMR) poses a significant threat to global public health.
• Prevalence of specific resistant bacteria varies globally, impacting treatment efficacy.
• Socioeconomic factors, such as national income, may influence AMR patterns.

Purpose of the Study:

• To investigate the relationship between a country's income status and the prevalence of key antimicrobial-resistant (AMR) bacteria.
• To assess the association between Gross National Income (GNI) per capita and AMR in third-generation cephalosporin (3GC)-resistant Escherichia coli, methicillin-resistant Staphylococcus aureus (MRSA), and 3GC-resistant Klebsiella species.

Main Methods:

• Utilized country-specific data from 2013-2014 from the ResistanceMap repository and the World Bank.
• Employed linear regression with robust standard errors to analyze the association between AMR prevalence and GNI per capita.
• Log-transformed GNI per capita to account for non-linear relationships.

Main Results:

• A significant negative association was observed between GNI per capita and the prevalence of MRSA, 3GC-resistant E. coli, and 3GC-resistant Klebsiella species.
• Models predicted decreases in prevalence for each log increase in GNI per capita: 11.3% for 3GC-resistant E. coli, 18.2% for 3GC-resistant Klebsiella species, and 12.3% for MRSA.
• The association was more pronounced for 3GC-resistant E. coli and Klebsiella species compared to MRSA.

Conclusions:

• Higher national income is significantly associated with lower prevalence of key resistant bacteria like MRSA and 3GC-resistant E. coli and Klebsiella.
• Findings emphasize the critical need for developing and implementing targeted policies to combat AMR, particularly in resource-limited settings.
• Addressing socioeconomic disparities is crucial for effective global AMR control strategies.