ArticleBMJ global health2026
Ambient temperature variations and antimicrobial resistance: a multicountry analysis of non-linear relationships and temperature thresholds.
Article in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Authors and funding
16 authors.
Funding
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Abstract
backgroundAntimicrobial resistance (AMR) is an escalating global health crisis being worsened by climate change. Studies of temperature-AMR associations remain limited by geographic scope, time frames and linear approaches. We aimed to identify temperature thresholds where AMR dynamics shift across pathogen-drug combinations, periods and socioeconomic contexts.
methodsWe analysed data from 56 countries and territories over 24 years (1999-2022), focusing on six WHO-designated 'critical' antibiotic-resistant pathogens. Using segmented regression models with mean ambient temperature as the primary independent variable, we divided the study period into three intervals (1999-2006, 2007-2014, 2015-2022) and incorporated 16 socioeconomic and environmental covariates. Model robustness was validated through bootstrap cross-validation with 1000 resamples.
findingsWe identified distinct temperature association thresholds for each pathogen-drug combination (5.7°C-18.4°C). Below these thresholds, resistance rates consistently decreased with rising temperatures; above thresholds, responses varied by phenotype and time period. For third-generation cephalosporin-resistant
interpretationPhenotype-specific temperature association thresholds provide descriptive, hypothesis-generating reference points for understanding how AMR burden varies along the global temperature gradient. The observed temporal heterogeneity suggests complex patterns requiring long-term monitoring and climate-adaptive AMR control strategies considering both phenotype-specific temperature sensitivities and socioeconomic contexts.
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