From gram-negative strains to mortality: understanding bacterial resistance in mainland China

Abstract

This study investigates the detection and resistance rates of major Gram-negative pathogens—Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii—across China, and examines their associations with climate, agriculture, economy, and diet. This study draws on data from the China Antimicrobial Resistance Surveillance System (CARSS) and the National Bureau of Statistics (NBS). From 2014 to 2021, bacterial cases rose significantly, with notable regional variations in detection and resistance rates. Descriptive statistics and double fixed-effects regression models were used analyze associations. Results indicate a steady increase in bacterial detection and resistance rates over time. Regional differences were pronounced. Environmental factors, including humidity, temperature, and rainfall were significantly correlated with these rates. Economic conditions and dietary patterns also showed relevant correlations. Overall, the study underscores the need for region-specific public health strategies, as local conditions significantly influence the spread and resistance of carbapenem-resistant bacteria. Besides, the analysis also shows that local conditions significantly influence the spread and resistance of carbapenem-resistant bacteria. Tailored interventions are essential for effective control of these public health threats.