Trends and socioeconomic, demographic, and environmental factors associated with antimicrobial resistance: a longitudinal analysis in 39 hospitals in Chile 2008-2017

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dc.contributor.authorAllel, Kasim
dc.contributor.authorLabarca, Jaime
dc.contributor.authorCarvajal, Camila
dc.contributor.authorGarcia, Patricia
dc.contributor.authorCifuentes, Marcela
dc.contributor.authorSilva, Francisco
dc.contributor.authorMunita, Jose M.
dc.contributor.authorUndurraga, Eduardo A.
dc.date.accessioned2025-01-20T20:10:38Z
dc.date.available2025-01-20T20:10:38Z
dc.date.issued2023
dc.description.abstractBackground Antimicrobial resistance (AMR) is among the most critical global health threats of the 21st century. AMR is primarily driven by the use and misuse of antibiotics but can be affected by socioeconomic and environmental factors. Reliable and comparable estimates of AMR over time are essential to making public health decisions, defining research priorities, and evaluating interventions. However, estimates for developing regions are scant. We describe the evolution of AMR for critical priority antibiotic-bacterium pairs in Chile and examine their association with hospital and community-level characteristics using multivariate rate-adjusted regressions. Methods Drawing on multiple data sources, we assembled a longitudinal national dataset to analyse AMR levels for critical priority antibiotic-bacterium combinations in 39 private and public hospitals (2008-2017) throughout the country and characterize the population at the municipality level. We first described trends of AMR in Chile. Second, we used multivariate regressions to examine the association of AMR with hospital characteristics and community-level socioeconomic, demographic, and environmental factors. Last, we estimated the expected distribution of AMR by region in Chile. Findings Our results show that AMR for priority antibiotic-bacterium pairs steadily increased between 2008 and 2017 in Chile, driven primarily by Klebsiella pneumoniae resistant to third-generation cephalosporins and carbapenems, and vancomycin-resistant Enterococcus faecium. Higher hospital complexity, a proxy for antibiotic use, and poorer local community infrastructure were significantly associated with greater AMR.Interpretation Consistent with research in other countries in the region, our results show a worrisome increase in clinically relevant AMR in Chile and suggest that hospital complexity and living conditions in the community may affect the emergence and spread of AMR. Our results highlight the importance of understanding AMR in hospitals and their interaction with the community and the environment to curtail this ongoing public health crisis.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.lana.2023.100484
dc.identifier.issn2667-193X
dc.identifier.urihttps://doi.org/10.1016/j.lana.2023.100484
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92086
dc.identifier.wosidWOS:001003614300001
dc.language.isoen
dc.revistaLancet regional health-americas
dc.rightsacceso restringido
dc.subjectAntimicrobial resistance
dc.subjectAntibiotics
dc.subjectLatin America
dc.subjectSocioeconomic
dc.subjectGlobal health
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleTrends and socioeconomic, demographic, and environmental factors associated with antimicrobial resistance: a longitudinal analysis in 39 hospitals in Chile 2008-2017
dc.typeartículo
dc.volumen21
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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