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Increasing Resistance to Extended-Spectrum Cephalosporins, Fluoroquinolone, and Carbapenem in Gram-Negative Bacilli and the Emergence of Carbapenem Non-Susceptibility in Klebsiella pneumoniae: Analysis of Korean Antimicrobial Resistance Monitoring System (KARMS) Data From 2013 to 2015

Authors
 Dokyun Kim  ;  Ji Young Ahn  ;  Chae Hoon Lee  ;  Sook Jin Jang  ;  Hyukmin Lee  ;  Dongeun Yong  ;  Seok Hoon Jeong  ;  Kyungwon Lee 
Citation
 Annals of Laboratory Medicine, Vol.37(3) : 231-239, 2017 
Journal Title
 Annals of Laboratory Medicine 
ISSN
 2234-3806 
Issue Date
2017
MeSH
Anti-Bacterial Agents/pharmacology* ; Asian Continental Ancestry Group ; Carbapenems/pharmacology ; Cephalosporins/pharmacology ; Databases, Factual ; Drug Resistance, Bacterial* ; Fluoroquinolones/pharmacology ; Gram-Negative Bacteria/drug effects* ; Gram-Negative Bacteria/isolation & purification ; Gram-Positive Bacteria/drug effects ; Gram-Positive Bacteria/isolation & purification ; Humans ; Klebsiella pneumoniae/drug effects* ; Klebsiella pneumoniae/isolation & purification ; Microbial Sensitivity Tests ; Republic of Korea ; Secondary Care Centers ; Tertiary Care Centers
Keywords
Acinetobacter baumannii ; Antimicrobial drug resistance ; KARMS ; Surveillance
Abstract
BACKGROUND: National surveillance of antimicrobial resistance becomes more important for the control of antimicrobial resistance and determination of treatment guidelines. We analyzed Korean Antimicrobial Resistance Monitoring System (KARMS) data collected from 2013 to 2015. METHODS: Of the KARMS participants, 16 secondary or tertiary hospitals consecutively reported antimicrobial resistance rates from 2013 to 2015. Data from duplicate isolates and institutions with fewer than 20 isolates were excluded. To determine the long-term trends, previous KARMS data from 2004 to 2012 were also considered. RESULTS: The prevalence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium from 2013 to 2015 was 66-72% and 29-31%, respectively. The resistance rates of Escherichia coli to cefotaxime and cefepime gradually increased to 35% and 31%, respectively, and fluoroquinolone resistance reached 48% in 2015. The resistance rates of Klebsiella pneumoniae to cefotaxime, cefepime, and carbapenem were 38-41%, 33-41%, and <0.1-2%, respectively, from 2013 to 2015. The carbapenem susceptibility rates of E. coli and K. pneumoniae decreased from 100% and 99.3% in 2011 to 99.0% and 97.0% in 2015, respectively. The resistance rate of Pseudomonas aeruginosa to carbapenem increased to 35% and the prevalence of carbapenem-resistant Acinetobacter baumannii increased from 77% in 2013 to 85% in 2015. CONCLUSIONS: Between 2013 and 2015, the resistance rates of E. coli to third- and fourth-generation cephalosporins increased continuously, while carbapenem-susceptibility gradually decreased, particularly in K. pneumoniae. The prevalence of carbapenem-resistant P. aeruginosa and A. baumannii increased significantly; therefore, few treatment options remain for these resistant strains.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161038
DOI
10.3343/alm.2017.37.3.231
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실)
Yonsei Authors
김도균(Kim, Dokyun)
용동은(Yong, Dong Eun)
이경원(Lee, Kyungwon)
이혁민(Lee, Hyuk Min)
정석훈(Jeong, Seok Hoon)
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