Unraveling the Mysteries Behind Resistance and Mortality in China's Carbapenem-Resistant Bacteria

Abstract Background: The current situation of bacterial resistance is severe. This study aimed to investigate the relationship between four Gram-negative bacteria and the environment, diet, and mortality. Methods: Data for this study were sourced from the China Antimicrobial Resistance Surveillance System (CARSS). monitoring the prev-alence of carbapenem-resistant Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii in 31provinces (city) over the period from 2014 to 2021. Subsequently, a comprehensive multivariate regression analysis was employed, culminating in the successful formulation of a logarithmic linear regression model. Result: The drug resistance rate of carbapenem-resistant Klebsiella pneumoniae was increasing year by year, and the mortality rate increases with the resistance level of Klebsiella pneumoniae. This study revealed that the most significant factors influencing the resistance of Escherichia coli and Pseudomonas aeruginosa are related to dietary habits, with egg consumption showing a positive correlation (Coefficient = 0.52, P<0.001) and beef consumption demonstrating a negative correlation (Coefficient = -0.558, P=0.036). In contrast, the resistance patterns of Klebsiella pneumoniae and Acinetobacter baumannii appear to be strongly associated with medical economy, as indicated by the number of hospitals (Coefficient for Klebsiella pneumoniae = 0.490, P<0.001; Coefficient for Acinetobacter baumannii = -0.735, P<0.001).