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Background Widely recognized as a major public health threat globally, the rapid increase of antibiotic resistance in bacteria could soon render our most effective method to combat infections obsolete. Factors influencing the burden of resistance in human populations remain poorly described, though temperature is known to play an important role in mechanisms of bacterial growth and transmission. Methods Here, we present the first evidence that ambient temperatures may modulate the rate of increase of antibiotic resistance across Europe. Using a comprehensive dataset containing information across 28 countries, for 17 years (2000–2016), 3 common bacterial pathogens, and 4 antibiotic classes collectively representing over 4 million tested isolates, we show that antibiotic resistance has increased more rapidly in warmer regions over a period of nearly 2 decades. Results Specifically, we show that European countries with 10°C warmer ambient temperatures have experienced more rapid increases in antibiotic resistance to E. coli and K. pneumoniae over the 17-year period, ranging between 0.33%/year (95% CI 0.2, 0.5) and 1.2%/year (0.4, 1.9), even after accounting for recognized drivers of resistance including antibiotic consumption and population density. We found a decreasing relationship for S. aureus and methicillin of -0.4%/year (95% CI −0.7, 0.0), reflecting widespread declines in MRSA across Europe over the study period. Conclusion Our findings suggest that rising temperatures globally may hasten the spread of resistance and complicate efforts to mitigate it. Disclosures All authors: No reported disclosures.

1605. Temperature Modulates the Rate of Increase of Antibiotic Resistance Across Europe