Panel data analysis of the effect of ambient temperature on antimicrobial resistance in China

Antimicrobial resistance (AMR) has been causing tremendous loss of life, health and economic property, and WHO identified carbapenem-resistant gram-negative (CRGN) as the most urgent bacteria. The impact of climate change on AMR has received worldwide attention, but the evidence is insufficient. The prevalence of carbapenem-resistant antibiotic-resistant Klebsiella pneumoniae (CRKP), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CRPA) from the Chinese Antibiotic Resistance Surveillance System from 2014 to 2023 were used as the dependent variable, the average ambient temperature from the China Statistical Yearbook was used as the independent variable. After controlling factors from socio-economic, environmental and medical services, natural log-linear regression analysis was used and found that CRKP and CRAB increased 1.093-fold and 1.021-fold, respectively, for every 1˚C ambient temperature increase. And this effect was similarly validated in the subgroup models for seasons and regions. In addition, we determined that health facilities, hospital beds per capita, and PM_2.5 had a significant effect on the AMR of different strains. Changes in ambient temperature have a cumulative effect, with the greatest cumulative four-year impact. The effects of ambient temperature and its changes on AMR and the identification of influencing factors in this study provide innovative insights and important evidence for combating AMR.