Table. Adjusted multivariable analyses to evaluate associations of antibiotic resistance with minimum temperature and other predictors, by pathogen and antibiotic subclass, European Union/European Economic Area countries and the United Kingdom, 2000–2016.
| Predictor | Coefficient (95% confidence interval)a | |||
|---|---|---|---|---|
| Aminoglycosides | Cephalosporins | Fluoroquinolones | Penicillinsb | |
| Escherichia coli | ||||
| Minimum temperature (°C) | −0.29 (−0.71 to 0.14) | −0.22 (−0.74 to 0.30) | −0.5 (−1.14 to 0.13) | −0.15 (−0.84 to 0.53) |
| Year | 0.34c (0.25 to 0.43) | 0.67c (0.56 to 0.77) | 0.68c (0.54 to 0.82) | 0.74c (0.59 to 0.89) |
| Minimum temperature (°C): year interaction | 0.03c (0.02 to 0.05) | 0.05c (0.04 to 0.07) | 0.06c (0.03 to 0.08) | 0 (−0.03 to 0.02) |
| Antibiotic consumption (log DDD/1,000 persons) | 0.32 (−0.00 to 0.64) | 0.44d (0.17 to 0.71) | 2.02c (1.03 to 3.00) | −0.62 (−2.07 to 0.84) |
| Population density (persons/km2) | −0.05 (−0.10 to 0.01) | −0.10d (−0.17 to −0.03) | −0.06 (−0.14 to 0.02) | 0.02 (−0.07 to 0.10) |
| R2 | 0.83 | 0.87 | 0.87 | 0.87 |
| Klebsiella pneumoniae | ||||
| Minimum temperature (°C) | −1.07 (−2.29 to 0.15) | −1.23 (−2.52 to 0.06) | −1.34 (−2.93 to 0.24) | N/A |
| Year | 0.56d (0.21 to 0.91) | 0.66c (0.29 to 1.02) | 0.92c (0.48 to 1.36) | N/A |
| Minimum temperature (°C): year interaction | 0.04 (−0.02 to 0.10) | 0.09d (0.03 to 0.15) | 0.12d (0.04 to 0.19) | N/A |
| Antibiotic consumption (log DDD/1,000 persons) | 0.19 (−0.83 to 1.20) | 0.90d (0.25 to 1.54) | 3.45d (0.89 to 6.01) | N/A |
| Population density (persons/km2) | 0.11 (−0.10 to 0.31) | 0.04 (−0.17 to 0.26) | −0.28 (−0.55 to −0.02) | N/A |
| R2 | 0.93 | 0.94 | 0.87 | N/A |
| Staphylococcus aureus | ||||
| Minimum temperature (°C) | N/A | N/A | N/A | 0.7 (−0.25 to 1.65) |
| Year | N/A | N/A | N/A | −0.04 (−0.23 to 0.15) |
| Minimum temperature (°C): year interaction | N/A | N/A | N/A | −0.04e (−0.07 to 0.00) |
| Antibiotic consumption (log DDD/1,000 persons) | N/A | N/A | N/A | 0.34 (−1.70 to 2.38) |
| Population density (persons/km2) | N/A | N/A | N/A | −0.29c (−0.41 to −0.17) |
| R2 | N/A | N/A | N/A | 0.87 |
N/A: data not available; DDD: number of defined daily doses (DDD) per day, from combined inpatient and outpatient sources.
a Except for the rows showing the R2.
b Penicillin resistance in E.coli was measured as resistance to aminopenicillins, and for S. aureus as resistance to meticillin.
c p < 0.001.
d p < 0.01.
e p < 0.05.
Coefficients with standard errors (95% confidence intervals) are adjusted for country, minimum temperature, year, population density, antibiotic consumption, and the interaction between year and minimum temperature. For interpretability, year is zeroed at baseline (2000). A natural log transform was applied to antibiotic consumption to improve linear fit. All available pathogen–antibiotic combinations of three pathogens (E. coli, K. pneumoniae, and S. aureus) and four antibiotic subclasses (aminoglycosides, 3rd-generation cephalosporins, fluoroquinolones, and penicillins) were analysed.