Abstract

Background Antibiotic resistance is considered as one of our greatest emerging public health threats. Current understanding of the factors governing spread of antibiotic-resistant organisms and mechanisms among populations is limited.Methods We explored the roles of local temperature, population density, and additional factors on the distribution of antibiotic resistance across the United States, using a database of regional antibiotic resistance that incorporates over 1.6 million bacterial pathogens from human clinical isolates over the years 2013–2015.ResultsWe identified that increasing local temperature as well as population density were associated with increasing antibiotic resistance in common pathogens. An increase in temperature of 10oC was associated with increases in antibiotic resistance of 4.2%, 2.2%, and 3.6% for the common pathogens Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. The effect of temperature on antibiotic resistance was robust across almost all classes of antibiotics and pathogens and strengthened over time.Conclusion These findings suggest that current forecasts of the burden of antibiotic resistance could be significant underestimates in the face of a growing population and warming planet.Figure 1.Antibiotic resistance increases with increasing temperature. (A) A heatmap of mean normalized antibiotic resistance for E. coli for all antibiotics across the USA. (B) A heatmap of 30-year average minimum temperature (oC) across the USA.Disclosures All authors: No reported disclosures.

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