Unmasking MRSA antibiotic resistance: the impact of environment, pollution, and healthcare quality—a nationwide exploration in China: a comprehensive analysis spanning 2014 to 2021 in mainland China

IF 6 3区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES Environmental Sciences Europe Pub Date : 2025-02-08 DOI:10.1186/s12302-025-01064-2

Yi-Chang Zhao, Ming-Xuan Xiao, Zhi-Hua Sun, Jia-Kai Li, Huai-yuan Liu, Bi-Kui Zhang, Hua-Lin Cai, Wei Cao, Feng Yu, Miao Yan

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引用次数: 0

Abstract

Background

The rise of antibiotic resistance has become a critical global health concern, resulting in numerous fatalities annually. Among resistant pathogens, methicillin-resistant Staphylococcus aureus (MRSA) poses a particularly severe and expanding threat. However, there is a lack of comprehensive studies on the prevalence, patterns, and contributing factors of MRSA resistance within mainland China.

Methods

In this study, the data of MRSA antimicrobial resistance in 31 provinces from 2014 to 2021 were obtained from the China Antimicrobial Resistance Surveillance System (CARSS). Environment and medical care data were obtained either from the National Bureau of Statistics (NBS) database or the National Ministry of Ecology and Environment (NMEE). Multiple linear regression and restricted cubic spline (RCS) was used to explore the potential influencing factors of MRSA antibiotic resistance rate (AMR).

Results

Significant positive associations were identified between MRSA AMR and various factors, including cadmium pollution, soybean and poultry production, and oil consumption. Conversely, an inverse J-shaped relationship was observed between tap water coverage and MRSA resistance. Other noteworthy correlations included the effects of corn and pork production, as well as antibiotic use intensity. Our predictive model explained 52.7% of the variability in MRSA AMR, demonstrating strong predictive capability.

Conclusions

This study highlights the significant role of environmental, agricultural, and healthcare factors in influencing MRSA AMR in China. The findings emphasize the need for integrated strategies addressing regional environmental and healthcare quality in combating antibiotic resistance. Extending this research globally could enhance understanding of MRSA resistance dynamics on a broader scale.

Graphical Abstract

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来源期刊

Environmental Sciences Europe Environmental Science-Pollution

CiteScore

11.20

自引率

1.70%

发文量

110

审稿时长

13 weeks

期刊介绍： ESEU is an international journal, focusing primarily on Europe, with a broad scope covering all aspects of environmental sciences, including the main topic regulation. ESEU will discuss the entanglement between environmental sciences and regulation because, in recent years, there have been misunderstandings and even disagreement between stakeholders in these two areas. ESEU will help to improve the comprehension of issues between environmental sciences and regulation. ESEU will be an outlet from the German-speaking (DACH) countries to Europe and an inlet from Europe to the DACH countries regarding environmental sciences and regulation. Moreover, ESEU will facilitate the exchange of ideas and interaction between Europe and the DACH countries regarding environmental regulatory issues. Although Europe is at the center of ESEU, the journal will not exclude the rest of the world, because regulatory issues pertaining to environmental sciences can be fully seen only from a global perspective.