Association Between Antimicrobial Resistance and Climatic Factors in Europe

Climatic factors, such as the mean warm-season temperature, significantly contribute to the prediction of antimicrobial resistance in different healthcare systems and societies, and climate change may increase the transmission of antimicrobial resistance, particularly the transmission of carbapenem-resistant Pseudmonas aeruginosa, according to research presented at the 29th European Congress of Clinical Microbiology & Infectious Diseases, held April 13 to 16, 2019, in Amsterdam, The Netherlands.

Antimicrobial resistance is a growing threat that has been recently associated with increasing temperatures in the United States. This 30-country observational study was designed to determine whether the association between climate variables and antimicrobial resistance was identifiable in regions with diverse healthcare systems and societies, using Europe as case region. The 6-year prevalence of carbapenem-resistant Klebsiella pneumoniae, carbapenem-resistant P aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), and multiresistant Escherichia coli was determined based on over 900, 000 isolates from the European Antimicrobial Resistance Surveillance Network (EARS-Net). Associations between antimicrobial resistance and warm/cold season temperatures were identified by performing bi- and multivariate analysis (log-linear models) under conditions of potential confounders.

Significant associations were found between MRSA, carbapenem-resistant K pneumoniae, and multiresistant E coli and mean warm-season temperature, which contributed more to the explanation for MRSA variance than outpatient antimicrobial drug use. For every 1.0-degree Celsius increase in temperature, there was a correlative increase of: 1.02 x MRSA (P =.0002), 1.03 x carbapenem-resistant K pneumoniae (P =.011), and 1.01 x multiresistant E coli (P =.003).

Carbapenem-resistant P aeruginosa was significantly associated with temperature change, with every 0.5-degree Celsius increase in temperature resulting in 1.02 x carbapenem-resistant P aeruginosa (P =.035). Antimicrobial resistance in 4 countries not included in the EARS-Net database was estimated using all obtained multivariate models, with varying degrees of accuracy compared with empirical data.

Study investigators concluded, “The present study identified a novel association between [antimicrobial resistance] and climatic factors in Europe. These results reveal 2 aspects: climatic factors significantly contribute to the prediction of [antimicrobial resistance]in different types of healthcare systems and societies, while climate change might increase [antimicrobial resistance] transmission, in particular [carbapenem-resistant P aeruginosa].”

Reference

Kaba H, Kuhlmann E, Scheithauer S. Novel association between antimicrobial resistance and climatic factors in Europe: a 30-country observational study. Presented at: The 29th European Congress of Clinical Microbiology & Infectious Diseases; April 13-16, 2019; Amsterdam, NL. Abstract 3045.