Association between antibiotic resistance and air pollution and climate factors in China: A multivariable...

In this study, we aimed to identify the spatiotemporal variation of antibiotic resistance and its relationship with environmental factors (air pollution and climate factors) in China.

The detection rate of carbapenem-resistant Klebsiella pneumoniae (CRKP) and Escherichia coli (CREC) in China from 2014 to 2022 was used to detect drug resistance. Air pollution factors include particulate matter and gaseous pollutants, and climate factors include temperature, precipitation and humidity. The spatial-temporal distributions and trend analyses were analyzed. Spatial autocorrelation analyses were performed to explore CRKP and CREC rates clustering. A geographically and temporally weighted regression model (GTWR) was adopted to analyze the relationship between antibiotic resistance rates and environmental factors.

We found that PM_2.5, O_3, annual average temperature and annual cumulative precipitation primarily had positive impacts on both CREC and CRKP rates. SO₂, NO_2, CO and annual average humidity predominantly exerted negative impacts on both CREC and CRKP rates. Meanwhile, the influence of related factors on CREC and CRKP shows temporal and spatial heterogeneity. Both CREC and CRKP exhibited significant spatial aggregation, displaying High-High and Low-Low patterns. Trend analysis indicated an upward trend for both in the east-west direction and an inverted U-shape in the north-south direction.

It is important to pay attention to the impact of air pollution and climate factors on antibiotic resistance.