ABSTRACT
The prime goal of molecular epidemiology is to identify the origin and evolution of pathogens, which can potentially influence the public health worldwide. Traditional methods provide limited information which is not sufficient for outbreak investigation and studying transmission dynamics. The recent advancement of next-generation sequencing had a major impact on molecular epidemiological studies. Currently, whole-genome sequencing (WGS) has become the gold standard typing method, especially for clinically significant pathogens. Here, we aimed to describe the application of appropriate molecular typing methods for global antimicrobial resistance surveillance system pathogens based on the level of discrimination and epidemiological settings. This shows that sequence-based methods such as multi-locus sequence typing (MLST) are widely used due to cost-effectiveness and database accessibility. However, WGS is the only method of choice for studying Escherichia coli and Shigella spp. WGS is shown to have higher discrimination than other methods in typing Klebsiella pneumoniae, Acinetobacter baumannii and Salmonella spp. due to its changing accessory genome content. For Gram positives such as Streptococcus pneumoniae, WGS would be preferable to understand the evolution of the strains. Similarly, for Staphylococcus aureus, combination of MLST, staphylococcal protein A or SCCmec typing along with WGS could be the choice for epidemiological typing of hospital- and community-acquired strains. This review highlights that combinations of different typing methods should be used to get complete information since no one standalone method is sufficient to study the varying genome diversity.
ABSTRACT
Growing resistance to antimicrobials has become one of the most important problems of the 21st century. The development of new antibiotics is a time-consuming process involving huge financial resources. An alternate approach is proper utilization of the existing antibiotics through the surveillance of resistance. An important component of surveillance is the informatics tool for collection, management and analysis of antimicrobial resistance susceptibility testing data. Based on the scope, antimicrobial resistance surveillance resistance tools can be broadly classified as collectors and integrators. Individually, both the integrators and collectors have limitations which restrict their use in India. There is a strong requirement to develop a hybrid AMR surveillance tool that captures standardized data from small laboratories and integrates data from multiple sources to present a complete picture of the country. Here we describe a tooli-AMRSS developed by the Indian Council of Medical Research for collection, storage and management of AMR data from collaborating institutes/laboratories and to generate real-time analytics and reports.
ABSTRACT
Antimicrobial resistance is a major concern globally. Infections due to drug-resistant pathogens are becoming difficult and a challenge to treat. As treatment choices are limited due to the high-drug resistance rates, there is an increase in the health care cost, duration of hospital stay, morbidity and mortality rates. Understanding the true burden of antimicrobial resistance for a geographical location is important to guide effective empirical therapy. To have a national data, it is imperative to have a systemic data capturing across the country through surveillance studies. Very few surveillance studies have been conducted in India to generate national data on antimicrobial resistance. This review aims to report the cumulative antibiogram and the resistance mechanisms of Global Antimicrobial Resistance Surveillance System (GLASS) priority pathogens from India.
ABSTRACT
Objective To investigate the antimicrobial resistance of bacterial isolates in Liuzhou Workers' Hospital in Guangxi during 2016.Methods Kirby-Bauer method or automated systems was employed to study the antimicrobial susceptibility.The data were analyzed according to CLSI 2015 breakpoints.Results A total of 5 485 bacterial strains were isolated from 48 908 specimens in Liuzhou Workers' Hospital during 2016,of which gram negative organisms accounted for 70.3％ and gram positive cocci 29.7％.The prevalence of methicillin-resistant strains was 18.3％ (83/454) in S.aureus and 72.5％ (232/320) in coagulase negative Staphylococcus.No staphylococcal strains were found resistant to vancomycin or linezolid.Of the 207 strains of non-meningitis S.pneumoniae,181 (87.4％) were isolated from children and 26 (12.6％) from adults.One E.faecium strain was identified as resistant to vancomycin.The prevalence of ESBLs-producing strains was 49.0％ (619/1 263) in E.coli and 31.8％ (202/636) in Klebsiella spp.Enterobacteriaceae strains were still highly susceptible to carbapenem antibiotics.Overall,0.6％ (14/2 326) and 1.5％ (36/2 326) of the Enterobacteriaceae strains were resistant to imipenem and meropenem,respectively.Conclusions Antibiotic-resistant bacterial strains,especially carbapenem-resistant Enterobacteriaceae,are posing an increasing threat to clinical practice.Special attention should be paid to ongoing surveillance of local antimicrobial resistance to inform standardized anti-infective treatment.
ABSTRACT
Objective To investigate the distribution and antibiotic resistance profile of clinical isolates in the First Affiliated Hospital of Bengbu Medical College in 2017. Methods Antimicrobial susceptibility testing was carried out by automated systems or Kirby-Bauer method. The data were interpreted according to CLSI 2017 breakpoints and analyzed by WHONET 5.6 software. Results A total of 4 295 strains of bacteria were isolated in 2017, including 1 196 (27.8％) strains of gram-positive bacteria, and 3 099 (72.2％) strains of gram-negative organisms. Methicillin-resistant Staphyloccus aureus and methicillin-resistant coagulasenegative Staphylococcus isolates accounted for 54.7％ and 77.4％, respectively. The resistance rates of methicillin-resistant strains to most of antibiotics tested (except trimethoprim-sulfamethoxazole) were significantly higher than those of methicillinsusceptible strains. None strains were found resistant to linezolid or vancomycin. E. faecium and E. faecalis were the major isolatesin Enterococcus. The resistance rates of E. faecalis to most antibiotics (except tetracyclines and linezolid) were much lower than those of E. faecium. A few Enterococcus strains were resistant to linezolid and vancomycin. A few strains of penicillin-resistant Streptococcus pneumoniae were identified. ESBLs-producing strains accounted for 66.0％ in E. coli and 22.7％ in K. pneumoniae. The resistance rate of Enterobacteriaceae to carbapenems was increasing. Theresistance rates of Klebsiella pneumoniae, Enterobacteriaceae and Citrobacter to imipenem and ertapenem were higher than 10％. The resistance rates of P. aeruginosa to imipenem was 43.3％, but lower than 30％ to ceftazidime, cefepime, piperacillin-tazobactam, and levofloxacin. The resistance rates of A. baumannii to all the antibiotics tested except amikacin were higher than 70％, and the resistance rate to imipenem was 87.5％. The prevalence of extensively drug-resistant strains in P. aeruginosa, K. pneumoniae and A. baumannii was 15.8％, 28.4％, and 46.7％, respectively. Conclusions Antimicrobial resistance was serious in this hospital in 2017. Especially, carbapenem-resistant Enterobacteriaceae and extensively drug-resistant K. pneumoniae were increasing. Therefore, more attention should be paid to rational use of antibiotics and antibiotic resistance surveillance.
ABSTRACT
Objective To investigate the antimicrobial resistance of clinical bacterial isolates in Peking Union Medical College Hospital (PUMCH) in 2017. Methods A total of 9 515 non-duplicate clinical isolates were collected from January 1 to December 31, 2017. Disc diffusion test (Kirby-Bauer method) and E-test method were employed to determine antimicrobial susceptibility. Results Gram-negative bacilli and gram-positive cocci accounted for 68.2％ and 31.8％, respectively among the 9 515 clinical isolates. Methicillin-resistant strains in S. aureus (MRSA) and coagulase-negative Staphylococcus (MRCNS) accounted for 25.6％ and 73.3％, respectively. Extended-spectrum β-lactamases (ESBLs) -producing strains accounted for 47.6％ (877/1 842), 27.6％ (335/1 213) and 33.0％ (59/179) in E. coli, Klebsiella spp (K. pneumoniae and K. oxytoca) and P. mirabilis, respectively. Enterbacteriaceae strains were still highly susceptible to carbapenems, with an overall resistance rate of ≤ 3.8％. The resistance rates of K. pneumoniae to imipenem and meropenem were 8.5％ and 8.2％, respectively. About 72.7％ and 70.4％ of A. baumannii isolateswere resistant to imipenem and meropenem. The resistance rate of P. aeruginosa to imipenem and meropenem was 14.8％ and 10.0％, respectively. The prevalence of extensively drug-resistant strains in A. baumannii, P. aeruginosa and K. pneumoniae was 31.7％ (239/753), 1.0％ (10/1 035), and 3.0％ (33/1 117), respectively. Conclusions The common bacterialisolates show various level of resistance to antimicrobial agents. Laboratory staff should improve communication with clinicians to prevent the spread of resistant strains.
ABSTRACT
Objective To analyze the antimicrobial resistance profile of clinical isolates in Shanghai Xinhua Hospital Chongming Branch affiliated to Shanghai Jiaotong University School of Medicine , a member of China Antimicrobial Resistance Surveillance System, during 2015, for the purpose to facilitate rational antimicrobial therapy. Methods Strain identification?and?susceptibility?testing?were?carried?out?for?the?clinical?isolates?using?MicroScan?WalkAway?96?Automated?Systems and Kirby-Bauer method. Results In 2015, a total of 1815 isolates were collected, including gram-negative bacteria (73.2 %) and gram-positive bacteria (26.8 %). The top three frequently isolated species were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. ESBL-producing strains were found in 36.3 % of the Escherichia coli isolates, 12.6 % of the Klebsiella (K. pneumoniae and K. oxytoca) isolates, and 28.0 % of the Proteus mirabilis isolates. The prevalence of carbapenem-resistant strains was 0.69 % in Enterobacteriaceae isolates. The prevalence of methicillin-resistant strain was 29.1 % in S. aureus, and 61.4 % in coagulase-negative Staphylococcus isolates. No more than 15 % of the Enterobacteriaceae isolates and no more than 20 % of the P. aeruginosa and Acinetobacter isolates were resistant to carbapenems. No vancomycin-or linezolid-resistant strains were found in Enterococcus or Staphylococcus. Conclusions Antibiotic-resistant clinical isolates are a serious threat for clinical antimicrobial treatment. We should pay more attention to such urgent situation and rational use of antibiotics.
ABSTRACT
Objective To investigate the distribution and antimicrobial resistance profile of the common pathogens isolated during the period from 2009 to 2015.Methods All the bacterial strains isolated from pediatric inpatients in Beijing Children's Hospital during the period from 2009 to 2015 were analyzed. Antimicrobial susceptibility was determined by disk diffusion method and Phoenix 100 Automated Microbiology System. Results were analyzed according to the guidelines of CLSI (2014) using WHONET 5.6 software.Results The total strains were 26630. The most common gram-positive isolates were Streptococcus pneumoniae,Staphylococcusaureusand coagulase-negative Staphylococcus (CNS), while the most frequently isolated gram-negative microorganisms were Klebsiella spp.,Pseudomonas aeruginosa and Escherichia coli. The prevalence of S. pneumoniae was up to 25.7 % (4101/15973) in all respiratory tract specimens. About 50.2 % of the S. pneumoniae isolates were not susceptible to penicillin. The prevalence of methicillin-resistant strains was 20.6 % in S. aureus (MRSA) and 87.8 % in coagulase negative Staphylococcus (MRCNS) on average. The prevalence of MRSA increased from 11.1 % in 2009 to 29.8 % in 2015. No S. pneumoniae or staphylococcal strains were found resistant to vancomycin or linezolid. The Enterococcus strains were still highly susceptible to vancomycin and linezolid. Overall 0.3 % of the Enterococcus faecium isolates were resistant to vancomycin. The extended-spectrum beta-lactamases (ESBLs) producing strains accounted for 71.4 % -78.1 % of E. coli and 65.1 % - 76.9 % of K. pneumoniae isolates. The carbapenem-resistant E. coli and K. pneumoniae were reported for the first time in 2010, but in 2014, the strains resistant to carbapenems had increased to more than 7 % in E. coli, and higher than 20 % in K. pneumoniae. In 2015, up to 27.7 % and 25.7 % of P. aeruginosa isolates were resistant to imipenem and meropenem, respectively, and 59.9 % of the A. baumannii isolates were resistant to imipenem and meropenem. Beta-lactamase was positive in 46.3 % of the H. influenzae isolates. Conclusions MRSA and the carbapenem-resistant strains of E. coli,K. pneumoniae and A. baumannii are still on the rise in pediatric inpatients, which poses a serious threat to clinical practice and implies the importance of strengthening infection control.
ABSTRACT
Antimicrobial resistance has been identified as one of the world′s most pressing public health threats.The number of antibiotic -resistant bacteria and the diversity of molecular mechanisms of resistance have in-creased sharply in recent years.The presence of antimicrobial resistance in children complicates patient management and arouses widespread concern.The use of antimicrobial agents is the single most important factor leading to the deve-lopment of resistance.New effective antimicrobial agents has been needed but has not kept pace.Antimicrobial -resis-tant infection can be prevented by immunization as well.Appropriate and judicious use of antimicrobial agents is the most important factors contributing to control resistance.Clinicians should collaborate well with microbiologist and know well about resistant bacteria and its proper antimicrobial drugs.A good application of antibiotic formulary restriction has the potential to decrease antimicrobial resistance.An antimicrobial resistance surveillance between regions and countries is urgently needed.It can help us to understand and slow antimicrobial resistance in the long run.
ABSTRACT
BACKGROUND: Antimicrobial surveillance is important for providing an up-to-date understanding of the epidemiology of antimicrobial resistance and for creating a forum for rational drug development. In this study, we analyzed antimicrobial test data generated in 2011 by hospitals and commercial laboratories participating in the Korean Nationwide Surveillance of Antimicrobial Resistance program (KONSAR). MATERIALS AND METHODS: Data on the results of susceptibility tests conducted in 32 hospitals and two commercial laboratories were analyzed. Data on isolates from patients admitted to an intensive care unit (ICU) and those admitted to other wards were compared. Intermediate susceptibility was not analyzed and duplicate isolates were excluded. RESULTS: Escherichia coli was the most prevalent organism identified in both the hospital and commercial laboratories. Among the hospital isolates, methicillin-resistant Staphylococcus aureus (MRSA), penicillin G-non-susceptible Streptococcus pneumoniae, and ampicillin-resistant Enterococcus faecium remained as prevalent as they were in 2009. The proportion of vancomycin-resistant E. faecium (VR-EFM) slightly decreased from 29% in 2009 to 23% in 2011. Resistance rates of Klebsiella pneumoniae to ceftazidime, cefoxitin, fluoroquinolone, and amikacin were 24%, 14%, 27%, and 8%, respectively. Resistance rates of Pseudomonas aeruginosa to fluoroquinolone, ceftazidime, imipenem, and amikacin were 33%, 20%, 22%, and 16%, respectively, whereas those of Acinetobacter spp. resistance were 71%, 66%, 64, and 51%, respectively. The prevalence of oxyimino-cephalosporin-resistant E. coli and K. pneumoniae, carbapenem-resistant Acinetobacter spp. and P. aeruginosa, MRSA, and VR-EFM among ICU isolates was higher than those among non-ICU isolates. Extended-spectrum beta-lactamase-producing E. coli and K. pneumoniae, imipenem-resistant P. aeruginosa, and VR-EFM were more prevalent among isolates from commercial laboratories than those from hospitals. Resistance rates of K. pneumoniae to ceftazidime and amikacin decreased from 32% and 24% in 2005 to 24% and 8% in 2011, respectively. The resistance rate of P. aeruginosa to amikacin decreased from 22% in 2005 to 16% in 2011. The proportion of imipenem-resistant Acinetobacter spp. increased from 16% in 2005 to 64% in 2011. CONCLUSIONS: The prevalence of MRSA, penicillin G-non-susceptible S. pneumoniae, and ampicillin-resistant E. faecium among clinical isolates tested in laboratories remained high. Multidrug resistance was more prevalent among isolates from ICUs. The prevalence of ceftazidime-resistant and amikacin-resistant K. pneumoniae and amikacin-resistant P. aeruginosa decreased after 2005, while the prevalence of imipenem-resistant Acinetobacter spp. increased.
Subject(s)
Humans , Acinetobacter , Amikacin , Cefoxitin , Ceftazidime , Drug Resistance, Multiple , Enterococcus faecium , Epidemiology , Escherichia coli , Imipenem , Intensive Care Units , Klebsiella pneumoniae , Korea , Methicillin-Resistant Staphylococcus aureus , Penicillins , Pneumonia , Prevalence , Pseudomonas aeruginosa , Salmonella , Staphylococcus , Streptococcus pneumoniaeABSTRACT
BACKGROUND: In general, higher resistance rates are observed among intensive care unit (ICU) isolates than non-ICU isolates. In this study, resistance rates of isolates from ICUs and non-ICUs were compared using the data generated from 20 hospitals in Korea. METHODS: Susceptibility data were collected from 20 hospitals participating in the Korean Nationwide Surveillance of Antimicrobial Resistance (KONSAR) program. Duplicate isolates were excluded from the analysis. The resistance rates did not include intermediate susceptibility. RESULTS: The most prevalent bacteria in the ICUs were Staphylococcus aureus (21%) and Acinetobacter spp. (19%), and those in non-ICU were Escherichia coli (27%) and S. aureus (14%). The resistance rates were higher in ICUs than in non-ICUs at 84% and 58% for methicillin-resistant S. aureus, 86% and 70% for methicillin-resistant coagulase-negative Staphylcoccus (CNS), 34% and 19% for vancomycin-resistant Enterococcus faecium, 38% and 19% for cefotaxime-resistant E. coli, 45% and 25% for cefotaxime-resistant Klebsiella pneumoniae, 42% and 24% for ceftazidime-resistant Enterobacter cloacae, 29% and 11% for ceftazidime-resistant Serattia marcescens, 83% and 44% for imipenem-resistant Acinetobacter spp., and 32% and 17% for imipenem-resistant Pseudomonas aeruginosa, respectively. CONCLUSION: The most prevalent bacteria in ICUs were S. aureus, CNS, and Acinetobacter spp., and high multi-drug resistance rates were observed in the Acinetobacter isolates. Therefore, infection control should be practiced in ICUs to prevent infections caused by multi-drug resistant bacteria.
Subject(s)
Acinetobacter , Bacteria , Drug Resistance, Multiple , Enterobacter cloacae , Enterococcus faecium , Escherichia coli , Infection Control , Intensive Care Units , Klebsiella pneumoniae , Korea , Methicillin Resistance , Pseudomonas aeruginosa , Staphylococcus aureusABSTRACT
PURPOSE: The increasing prevalence of antimicrobial resistant bacteria has become a serious worldwide problem. The aim of this study was to analyze antimicrobial resistance data generated in 2009 by hospitals and commercial laboratories participating in the Korean Nationwide Surveillance of Antimicrobial Resistance program. MATERIALS AND METHODS: Susceptibility data were collected from 24 hospitals and two commercial laboratories. In the analysis, resistance did not include intermediate susceptibility. Duplicate isolates were excluded from the analysis of hospital isolates, but not from the commercial laboratory isolates. RESULTS: Among the hospital isolates, methicillin-resistant Staphylococcus aureus, penicillin G-non-susceptible Streptococcus pneumoniae based on meningitis breakpoint, and ampicillin-resistant Enterococcus faecium remained highly prevalent. The proportion of vancomycin-resistant E. faecium gradually increased to 29%. Ceftazidime-resistant Escherichia coli and Klebsiella pneumoniae increased to 17% and 33%, respectively, and fluoroquinolone-resistant K. pneumoniae, Acinetobacter spp. and Pseudomonas aeruginosa increased to 33%, 67% and 39%, respectively. Amikacin-resistant Acinetobacter spp. increased to 48%. Imipenem-resistant Acinetobacter spp. and P. aeruginosa increased to 51% and 26%, respectively. Higher resistance rates were observed in intensive care unit (ICU) isolates than in non-ICU isolates among the isolates from hospitals. Resistance rates were higher in hospital isolates than in clinic isolates among the isolates from commercial laboratories. CONCLUSION: Among the hospital isolates, ceftazidime-resistant K. pneumoniae and fluoroquinolone-resistant K. pneumoniae, Acinetobacter spp., and P. aeruginosa further increased. The increase in imipenem resistance was slight in P. aeruginosa, but drastic in Acinetobacter spp. The problematic antimicrobial-organism combinations were much more prevalent among ICU isolates.
Subject(s)
Humans , Acinetobacter/drug effects , Acinetobacter Infections/drug therapy , Amikacin/pharmacology , Anti-Bacterial Agents/pharmacology , Carbapenems/pharmacology , Cross Infection/drug therapy , Drug Resistance, Bacterial , Fluoroquinolones/pharmacology , Pseudomonas Infections/drug therapy , Pseudomonas aeruginosa/drug effects , Republic of KoreaABSTRACT
PURPOSE: Antimicrobial resistance monitoring could be a useful source of information for treating and controlling nosocomial infections. We analyzed antimicrobial resistance data generated by Korean Hospitals and by a commercial laboratory in 2005 and 2007. MATERIALS AND METHODS: Susceptibility data for 2005 and 2007 were collected from 37 and 41 hospitals, respectively, and from one commercial laboratory. Intermediate susceptibility was not included in the calculation of resistance rates. RESULTS: Methicillin-resistant Staphylococcus aureus (MRSA) (64%), third-generation cephalosporin-resistant Klebsiella pneumoniae (29%), fluoroquinolone-resistant Escherichia coli (27%), Pseudomonas aeruginosa (33%), and Acinetobacter spp. (48%), and amikacin-resistant P. aeruginosa (19%) and Acinetobacter spp. (37%) were prevalent in hospitals in 2007. A gradual increase of vancomycin-resistant Enterococcus faecium and imipenem-resistant Acinetobacter spp. was observed. Higher incidences of third-generation cephalosporin-resistant E. coli and K. pneumoniae and imipenem-resistant P. aeruginosa were found in the commercial laboratory than in the hospitals. CONCLUSION: Methicillin-resistant S. aureus, third-generation cephalosporin-resistant K. pneumoniae, and fluoroquinolone-resistant E. coli, P. aeruginosa and Acinetobacter spp. remain prevalent in Korea, while the incidence of vancomycin-resistant E. faecium and imipenem-resistant Acinetobacter spp. has increased gradually. The higher prevalences of third-generation cephalosporin-resistant E. coli and K. pneumoniae, and imipenem-resistant P. aeruginosa in the commercial laboratory are a new concern.
Subject(s)
Humans , Acinetobacter/metabolism , Bacterial Infections/drug therapy , Ceftazidime/pharmacology , Cross Infection/drug therapy , Drug Resistance, Bacterial , Escherichia coli/metabolism , Fluoroquinolones/pharmacology , Imipenem/pharmacology , Klebsiella Infections/drug therapy , Klebsiella pneumoniae/metabolism , Methicillin-Resistant Staphylococcus aureus/metabolism , Pseudomonas aeruginosa/metabolism , Republic of Korea , Vancomycin/pharmacologyABSTRACT
Objective:To investigate the Acinetobacter baumannii’s distribution feature、the antimicrobial resistance of Acinetobacter baumannii isolated during the past 4 years and compare antibacterial activity of Polymyxin B against multidrug-resisitant(MDR) Acinetobacter baumannii with that of Imipenem in vitro.Methods:The distribution feature of infection caused by Acinetobacter baumannii was supervised.Disk diffusion test was used to study the antimicrobial agents resistance of Acinetobacter baumannii and transition of drug resistance.The results were evaluated based on Clinical and Laboratory Standards Institute(CLSI).The MDR Acinetobacter baumannii were screened by WHONET 5.MICs(minimal inhibitory concentration)of Polymyxin B and imipenem were detected by broth dilution method.Results:Constituent ratio of infections caused by Acinetobacter baumannii had been incresed in the recent 4 years,especially in intensive care unit.Although carbapenems were the most active antibiotics tested against Acinetobacter baumannii,the resistance rate had been sharply raised since 2008.In addition,the ratio of MDR Acinetobacter baumannii had also been raised in the 4 years.The results of MIC displayed that Polymyxin B had the higher antibacterial activity against the MDR Acinetobacter baumannii than Imipenem. Conclusion:Proportion of nosocomial infection caused by Acinetobacter baumannii significantly increased.The resistance rate of Acinetobacter baumannii had been rised obviously and the number of MDR Acinetobaeter baumannii had been increased sharply. Monitoring of the antimicrobial agents resistance to Acinetobacter baumannii should be strengthened.Polymyxin B still shows strong antibacterial activity on the MDR Acinetobacter baumannii in vitro.We can consider using Polymyxin B to treat the severe infections caused by MDR Acinetobacter baumannii.
ABSTRACT
Monitoring temporal trends of antimicrobial resistance can provide useful information for the empirical selection of antimicrobial agents to treat infected patients and for the control of nosocomial infections. In this study, we analyzed antimicrobial resistance of clinically relevant bacteria in 2003 at Korean hospitals and at a commercial laboratory. The following organism-antimicrobial agent resistance combinations were very prevalent: oxacillin-resistant Staphylococcus aureus (68%), expanded-spectrum cephalosporin-resistant Klebsiella pneumoniae (25%), and fluoroquinolone-resistant Escherichia coli (33%), Acinetobacter spp. (58%), and Pseudomonas aeruginosa (40%). Moreover, gradual increases in vancomycin-resistant Enterococcus faecium (20%), cefoxitin-resistant E. coli (10%) and K. pneumoniae (23%), and imipenem-resistant P. aeruginosa (20%) and Acinetobacter spp. (13%) were also observed. The resistance rates of Acinetobacter spp. to most antimicrobial agents at hospitals and at the commercial laboratory were similar. Among the Acinetobacter spp. isolated at a tertiary-care hospital, 46.2% were multidrug-resistant to 9-12 of 13 antimicrobial agents, and 18.3% were panresistant. The exclusion of duplicate isolates at a tertiary-care hospital significantly lowered the proportion of oxacillin-resistant S. aureus, vancomycin-resistant E. faecium, and fluoroquinolone-resistant E. coli.
Subject(s)
Humans , Vancomycin Resistance , Vancomycin/pharmacology , Population Surveillance , Microbial Sensitivity Tests , Korea/epidemiology , Klebsiella pneumoniae/drug effects , Klebsiella Infections/drug therapy , Imipenem/pharmacology , Gram-Positive Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/drug therapy , Gammaproteobacteria/drug effects , Fluoroquinolones/pharmacology , Enterococcus faecium/drug effects , Drug Resistance, Bacterial , Anti-Bacterial Agents/pharmacology , Amikacin/pharmacology , Acinetobacter Infections/drug therapy , Acinetobacter/drug effectsABSTRACT
A nationwide antimicrobial resistance surveillance has been conducted since 1997 in Korea. In this study, susceptibility test data generated in 2004 by KONSAR group hospitals were analyzed and compared to those at a commercial laboratory. In hospitals, the rank orders of organisms in 2004 were identical to those in 2003. The most prevalent species was Staphylococcus aureus (20.2%) in hospitals, but Escherichia coli (29.7%) in the commercial laboratory. The proportions of Enterococcus faecium to all isolates of Enterococcus faecalis plus E. faecium were 47.2% in hospitals and 24.9% in the commercial laboratory. The mean resistance rates of significant antimicrobial-organism combinations in hospitals were: oxacillin-resistant S. aureus (68%), oxacillin-resistant (penicillin- nonsusceptible) Streptococcus pneumoniae (68%), vancomycin-resistant E. faecium (25%), cefotaxime-resistant E. coli (14%), ceftazidime- and cefoxitin-resistant Klebsiella pneumoniae (34% and 32%, respectively), and imipenem-resistant Acinetobacter spp. and Pseudomonas aeruginosa (17% and 24%, respectively). In conclusion, oxacillin-resistant staphylococci, expanded-spectrum cephalosporin-resistant K. pneumoniae, and imipenem-resistant Acinetobacter spp. and P. aeruginosa were prevalent in 2004. Increasing trends were observed for vancomycin-resistant E. faecium, cefoxitin- resistant E. coli and K. pneumoniae, and imipenem-resistant Acinetobacter spp. and P. aeruginosa. Certain antimicrobial- organism combinations were also prevalent among the commercial laboratory-tested strains.