The Global Antimicrobial Resistance Trends of Staphylococcus aureus and Influencing Factors
Haitao Yuan, Jie Xu, Ying Wang, Yuan Li, Yuqing Hao, Jinzhao Long, Fang Liu, Jingyuan Zhu, Haiyan Yang
Abstract
The increase in the antimicrobial resistance (AMR) of Staphylococcus aureus (S. aureus) has become a global public health concern. This study globally monitored the large-scale longitudinal trend of AMR in S. aureus and examined the various human and environmental climate factors that influence the occurrence and spread of AMR in S. aureus, which might provide valuable data to support the development of a global surveillance system for S. aureus AMR and provide a theoretical basis for coordinated actions to control the emergence and development of AMR from multiple perspectives. There was a significantly positive correlation between the number of antibiotic resistance genes (ARGs) in S. aureus and the collection year, with a sharp increase in ARGs over time. The number of ARGs in S. aureus genomes significantly increased each decade, with the average number of ARGs per genome rising from 10.37 ± 3.55 before 1990 to 12.75 ± 4.04 after 2010, suggesting a growing problem of S. aureus AMR. The Spearman correlation results indicated that the human development index (HDI), antibiotic consumption, and mobile genetic elements (MGEs) were significantly associated with the AMR of S. aureus, and these factors played a crucial role in the emergence and development of S. aureus AMR. The results of structural equation modeling showed that the HDI significantly promoted an increase in antibiotic consumption, thereby indirectly enhancing the AMR of S. aureus. Antibiotic consumption also indirectly facilitated the progression of AMR in S. aureus through its impact on MGEs. The results of restricted cubic spline and generalized linear models showed that climate change also played a significant role in the progression of S. aureus AMR. In summary, this study provides a theoretical framework for monitoring the longitudinal trend of ARGs in S. aureus isolates and examining the possible influencing variables of ARGs in these isolates.