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Antibiotic resistance increases with local temperature

Abstract

Bacteria that cause infections in humans can develop or acquire resistance to antibiotics commonly used against them1,2. Antimicrobial resistance (in bacteria and other microbes) causes significant morbidity worldwide, and some estimates indicate the attributable mortality could reach up to 10 million by 20502,3,4. Antibiotic resistance in bacteria is believed to develop largely under the selective pressure of antibiotic use; however, other factors may contribute to population level increases in antibiotic resistance1,2. We explored the role of climate (temperature) and additional factors on the distribution of antibiotic resistance across the United States, and here we show that increasing local temperature as well as population density are associated with increasing antibiotic resistance (percent resistant) in common pathogens. We found that an increase in temperature of 10 °C across regions was associated with an increases in antibiotic resistance of 4.2%, 2.2%, and 2.7% for the common pathogens Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus. The associations between temperature and antibiotic resistance in this ecological study are consistent across most classes of antibiotics and pathogens and may be strengthening over time. These findings suggest that current forecasts of the burden of antibiotic resistance could be significant underestimates in the face of a growing population and climate change4.

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Fig. 1: Antibiotic resistance increases with increasing temperature.
Fig. 2: Change in the relationship between minimum temperature and antibiotic resistance over time.

References

  1. 1.

    Holmes, A. H. et al. Understanding the mechanisms and drivers of antimicrobial resistance. Lancet 387, 176–187 (2016).

    CAS  Article  Google Scholar 

  2. 2.

    Nathan, C. & Cars, O. Antibiotic resistance—problems, progress, and prospects. N. Engl. J. Med. 371, 1761–1763 (2014).

    Article  Google Scholar 

  3. 3.

    Global Action Plan on Antimicrobial Resistance (World Health Organization, 2015).

  4. 4.

    O’Neill, J. Tackling Drug-Resistant Infections Globally: Final Report and Recommendations (HM Government and Wellcome Trust, 2016).

  5. 5.

    Patz, J. A. et al. in Climate Change and Human Health: Risks and Responses (eds McMichael, A. J. et al.) Ch. 6 (World Health Organization, Geneva, 2003); www.who.int/globalchange/environment/en/chapter6.pdf

  6. 6.

    Feero, W. G., Guttmacher, A. E. & Relman, D. A. Microbial genomics and infectious diseases. N. Engl. J. Med 365, 347–357 (2011).

    Article  Google Scholar 

  7. 7.

    Wellington, E. M. H. et al. The role of the natural environment in the emergence of antibiotic resistance in Gram-negative bacteria. Lancet Infect. Dis. 13, 155–165 (2013).

    CAS  Article  Google Scholar 

  8. 8.

    Lorenz, M. G. & Wackernagel, W. Bacterial gene transfer by natural genetic transformation in the environment. Microbiol. Rev. 58, 563–602 (1994).

    CAS  Google Scholar 

  9. 9.

    Walsh, T. R., Weeks, J., Livermore, D. M. & Toleman, M. A. Dissemination of NDM-1 positive bacteria in the New Delhi environment and its implications for human health: an environmental point prevalence study. Lancet Infect. Dis. 11, 355–362 (2011).

    Article  Google Scholar 

  10. 10.

    MacFadden, D. R. et al. A platform for monitoring regional antimicrobial resistance, using online data sources: ResistanceOpen. J. Infect. Dis. 214, S393–S398 (2016).

    Article  Google Scholar 

  11. 11.

    Fridken, S. Antibiotic Resistance Patient Safety Atlas (Centers for Disease Control and Prevention, 2016); https://gis.cdc.gov/grasp/PSA/indexAU.html

  12. 12.

    General Population and Housing Characteristics: 2010 Demographic Profile (US Census Bureau, 2010); https://factfinder.census.gov

  13. 13.

    Peleg, A. Y. & Hooper, D. C. Hospital-acquired infections due to Gram-negative bacteria. N. Engl. J. Med. 362, 1804–1813 (2010).

    CAS  Article  Google Scholar 

  14. 14.

    Boucher, H. W. et al. Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America. Clin. Infect. Dis. 48, 1–12 (2009).

    Article  Google Scholar 

  15. 15.

    Arguez, A. et al. NOAA’s 1981–2010 US NOAA’s 1981–2010 U.S. climate normals: an overview. Bull. Am. Meteorol. Soc. 93, 1687–1697 (2012).

    Article  Google Scholar 

  16. 16.

    Sutherst, R. W. Global change and human vulnerability to vector-borne diseases. Clin. Microbiol. Rev. 17, 136–173 (2004).

    Article  Google Scholar 

  17. 17.

    Clarke, A. et al. A low temperature limit for life on Earth. PLoS ONE 8, e66207 (2013).

    CAS  Article  Google Scholar 

  18. 18.

    Hicks, L. A., Taylor, T. H. Jr & Hunkler, R. J. US outpatient antibiotic prescribing, 2010. N. Engl. J. Med. 368, 1461–1462 (2013).

    CAS  Article  Google Scholar 

  19. 19.

    Hicks, L. A. et al. US outpatient antibiotic prescribing variation according to geography, patient population, and provider specialty in 2011. Clin. Infect. Dis. 60, 1308–1316 (2015).

    Google Scholar 

  20. 20.

    Hilty, M. et al. Transmission dynamics of extended-spectrum β-lactamase-producing Enterobacteriaceae in the tertiary care hospital and the household setting. Clin. Infect. Dis. 55, 967–975 (2012).

    Article  Google Scholar 

  21. 21.

    Warnes, S. L., Highmore, C. J. & Keevil, C. W. Horizontal transfer of antibiotic resistance genes on abiotic touch surfaces: implications for public health. mBio 3, e00489 (2012).

    CAS  Article  Google Scholar 

  22. 22.

    Goossens, H., Ferech, M., van der Stichele, R., Elseviers, M. & ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet 365, 579–587 (2005).

    Article  Google Scholar 

  23. 23.

    Poirel, L., Potron, A. & Nordmann, P. OXA-48-like carbapenemases: the phantom menace. J. Antimicrob. Chemother. 67, 1597–1606 (2012).

    CAS  Article  Google Scholar 

  24. 24.

    Liu, Y.-Y. et al. Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study. Lancet Infect. Dis. 16, 161–168 (2016).

    Article  Google Scholar 

  25. 25.

    Shah, H. N. & Gharbia, S. E. The impact of the environment on human infections. Microb. Ecol. Health Dis. 11, 248–254 (1999).

    Article  Google Scholar 

  26. 26.

    Ratkowsky, D. A., Olley, J., Mcmeekin, T. A. & Ball, A. A. Relationship between temperature and growth rate of bacterial cultures. J. Bacteriol. 149, 1–5 (1982).

    CAS  Google Scholar 

  27. 27.

    Dipl-Vw, K. K., Frank, U., Conrad, A. & Meyer, E. Seasonal and ascending trends in the incidence of carriage of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella species in 2 German hospitals. Infect. Control Hosp. Epidemiol. 31, 1154–1159 (2010).

    Article  Google Scholar 

  28. 28.

    Perencevich, E. N. et al. Summer peaks in the incidences of Gram-negative bacterial infection among hospitalized patients. Infect. Control Hosp. Epidemiol. 29, 1124–1131 (2008).

    Article  Google Scholar 

  29. 29.

    Mermel, L. A., Machan, J. T., Parenteau, S., Brown, S. M. & Jones, K. Seasonality of MRSA infections. PLoS ONE 6, e17925 (2011).

    CAS  Article  Google Scholar 

  30. 30.

    Gautam, R. et al. Modeling the effect of seasonal variation in ambient temperature on the transmission dynamics of a pathogen with a free-living stage: example of Escherichia coli O157:H7 in a dairy herd. Prev. Vet. Med. 102, 10–21 (2011).

    Article  Google Scholar 

  31. 31.

    Levin, B. R. Minimizing potential resistance: a population dynamics view. Clin. Infect. Dis. 33, S161–S169 (2001).

    CAS  Article  Google Scholar 

  32. 32.

    IPCC Climate Change 2013: The Physical Science Basis (eds Stocker, T. F. et al.) (Cambridge Univ. Press, 2014).

  33. 33.

    Bruinsma, N. et al. Influence of population density on antibiotic resistance. J. Antimicrob. Chemother. 51, 385–390 (2003).

    CAS  Article  Google Scholar 

Download references

Acknowledgements

D.R.M. is supported by a Canadian Institute for Health Research Fellowship Grant and the Clinician Scientist Program at the Department of Medicine, University of Toronto. J.S.B. is supported by the National Library of Medicine NIH R01 LM011965. Thank you to the developers and data analysts at HealthMap for their support. Thank you to M. Kramer for his thoughtful and insightful review and feedback.

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D.R.M., S.F.M. and M.S. contributed to the data analysis. All the authors (D.R.M., S.F.M., D.F., M.S. and J.S.B.) contributed to development of the manuscript, discussion and preparation of final versions. All the authors approved the final version of the manuscript.

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Correspondence to Derek R. MacFadden or Mauricio Santillana or John S. Brownstein.

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The authors declare no competing interests.

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Supplementary figures 1–8, Supplementary tables 1–4

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MacFadden, D.R., McGough, S.F., Fisman, D. et al. Antibiotic resistance increases with local temperature. Nature Clim Change 8, 510–514 (2018). https://doi.org/10.1038/s41558-018-0161-6

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