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
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 co...
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2025-02-01
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| Series: | Environmental Sciences Europe |
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| Online Access: | https://doi.org/10.1186/s12302-025-01064-2 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Yi-Chang Zhao |
| collection | DOAJ |
| description | 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 |
| format | Article |
| id | doaj-art-8ee326a5b6c4400b97aa391888588972 |
| institution | Kabale University |
| issn | 2190-4715 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Environmental Sciences Europe |
| spelling | doaj-art-8ee326a5b6c4400b97aa3918885889722025-02-09T12:24:49ZengSpringerOpenEnvironmental Sciences Europe2190-47152025-02-0137111410.1186/s12302-025-01064-2Unmasking 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 ChinaYi-Chang Zhao0Ming-Xuan Xiao1Zhi-Hua Sun2Jia-Kai Li3Huai-yuan Liu4Bi-Kui Zhang5Hua-Lin Cai6Wei Cao7Feng Yu8Miao Yan9The Second Xiangya Hospital, Central South UniversityInternational Research Center for Precision Medicine, Transformative Technology and Software ServicesInternational Research Center for Precision Medicine, Transformative Technology and Software ServicesThe Second Xiangya Hospital, Central South UniversityInternational Research Center for Precision Medicine, Transformative Technology and Software ServicesThe Second Xiangya Hospital, Central South UniversityThe Second Xiangya Hospital, Central South UniversityThe Second Xiangya Hospital, Central South UniversitySchool of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical UniversityThe Second Xiangya Hospital, Central South UniversityAbstract 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 Abstracthttps://doi.org/10.1186/s12302-025-01064-2Antibacterial resistanceEnvironmental pollutionSurveillanceMainland ChinaMethicillin-resistant Staphylococcus aureus |
| spellingShingle | 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 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 Environmental Sciences Europe Antibacterial resistance Environmental pollution Surveillance Mainland China Methicillin-resistant Staphylococcus aureus |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Antibacterial resistance Environmental pollution Surveillance Mainland China Methicillin-resistant Staphylococcus aureus |
| url | https://doi.org/10.1186/s12302-025-01064-2 |
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