Abstract
The Korean government established an antimicrobial resistance (AMR) surveillance system, compatible with the Global AMR Surveillance System (GLASS): Kor-GLASS. We describe results from the first year of operation of the Kor-GLASS from May 2016 to April 2017, comprising all non-duplicated clinical isolates of major pathogens from blood, urine, faeces and urethral and cervical swabs from six sentinel hospitals. Antimicrobial susceptibility tests were carried out by disk diffusion, Etest, broth microdilution and agar dilution methods. Among 67,803 blood cultures, 3,523 target pathogens were recovered. The predominant bacterial species were Escherichia coli (n = 1,536), Klebsiella pneumoniae (n = 597) and Staphylococcus aureus (n = 584). From 57,477 urine cultures, 6,394 E. coli and 1,097 K. pneumoniae were recovered. Bloodstream infections in inpatients per 10,000 patient-days (10TPD) were highest for cefotaxime-resistant E. coli with 2.1, followed by 1.6 for meticillin-resistant Sta. aureus, 1.1 for imipenem-resistant Acinetobacter baumannii, 0.8 for cefotaxime-resistant K. pneumoniae and 0.4 for vancomycin-resistant Enterococcus faecium. Urinary tract infections in inpatients were 7.7 and 2.1 per 10TPD for cefotaxime-resistant E. coli and K. pneumoniae, respectively. Kor-GLASS generated well-curated surveillance data devoid of collection bias or isolate duplication. A bacterial bank and a database for the collections are under development.
Highlights
Antimicrobial resistance (AMR) is a growing burden in both clinical and socioeconomic context owing to the high morbidity and prolonged hospitalisation of patients that causes elevated medical and societal costs because of loss of productivity [1]
Korean AMR Monitoring System (KARMS) played an important role in notifying the high antimicrobial resistance (AMR) rates in South Korea, urging the government to develop a national action plan
We assessed the relative incidence of bloodstream infection (BSI) caused by E. coli compared with other species: The relative ratio of E. coli to Sta. aureus in Kor-Global AMR Surveillance System (GLASS) was moderate at 2.6, which was lower than the 3.2 observed in Norway [10], similar to the ratios of 2.4 in Taiwan [11] and 2.2 in Netherlands [12], and higher than the ratios of 1.2 in Japan [13], 1.2 in Vietnam [14], 1.0 in Greece [15] and 1.1 in Malawi [16]
Summary
Antimicrobial resistance (AMR) is a growing burden in both clinical and socioeconomic context owing to the high morbidity and prolonged hospitalisation of patients that causes elevated medical and societal costs because of loss of productivity [1]. The World Health Organization launched the Global AMR Surveillance System (GLASS) in 2015 [2] as a core global action plan addressing this issue. KARMS played an important role in notifying the high AMR rates in South Korea, urging the government to develop a national action plan. The epidemiological interpretation of the study was limited because of insufficient clinical data
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