Journal article
A multivariable analysis of the contribution of socioeconomic and environmental factors to blood culture Escherichia coli resistant to fluoroquinolones in high- and middle-income countries
- Abstract:
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Background:
Antimicrobial resistance (AMR) is a public health concern. We wanted to determine if various environmental and socioeconomic variables as well as markers of antimicrobial use impacted on the level of AMR in countries of different income levels.
Methods:
We performed cross-national univariate and multivariable analyses using the national proportion of quinolone-resistant Escherichia coli (QREC) in blood culture as the dependent variable. Access to safe water and sanitation, other socioeconomic variables, and human and animal antimicrobial consumption were analysed.
Results:
In middle-income countries, unsafely managed sanitation, corruption and healthcare access and quality were significantly associated with the national proportion of blood culture QREC (%) in univariate analyses, whereas no variables remained significant in the multivariable models. For the multivariable high-income country model, corruption and healthcare access and quality were significantly associated with blood culture QREC (%) levels. For the model including all countries, human fluoroquinolone use, corruption level, livestock and crop production index were significantly associated with blood culture QREC (%) levels in the univariate analyses.
Conclusion:
Corruption is a strong predictor of AMR, likely reflecting a multitude of socioeconomic factors. Sanitation quality contributed to increased blood culture QREC (%) levels in middle-income countries, although was not an independent factor, highlighting the need to also focus on infrastructure such as sanitation services in the context of AMR.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Supplementary materials, pdf, 295.3KB, Terms of use)
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(Preview, Version of record, pdf, 1.4MB, Terms of use)
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- Publisher copy:
- 10.1186/s12889-022-12776-y
Authors
+ Norwegian Agency for Development Cooperation
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- Funder identifier:
- https://ror.org/04zbn7k04
- Publisher:
- BioMed Central
- Journal:
- BMC Public Health More from this journal
- Volume:
- 22
- Issue:
- 1
- Article number:
- 354
- Publication date:
- 2022-02-19
- Acceptance date:
- 2022-02-02
- DOI:
- EISSN:
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1471-2458
- Language:
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English
- Keywords:
- Pubs id:
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2129197
- Local pid:
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pubs:2129197
- Deposit date:
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2025-06-11
- ARK identifier:
Terms of use
- Copyright holder:
- Booth and Wester
- Copyright date:
- 2022
- Rights statement:
- © The Author(s) 2022, corrected publication 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Notes:
- A correction to this article was published on 18 March 2022 at https://doi.org/10.1186/s12889-022-12896-5
- Licence:
- CC Attribution (CC BY)
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