국가 항생제 내성 감시체계 Kor-GLASS의 현황과 전망

Abstract

Antimicrobial-resistant bacteria have been increasingly reported worldwide, and surveillance plays an important role in preventing the further dissemination of these organisms. The World Health Organization suggested the Global Antimicrobial Resistance Surveillance System (GLASS) as a part of a global action plan in 2015. The purpose of GLASS was to establish a worldwide surveillance system to collect standardized, comparable, and validated antimicrobial resistance (AMR) data, which would enable the comparison of AMR data by country. The Korean government established a new AMR surveillance system, namely Kor-GLASS, based on the GLASS platform in 2016. Kor-GLASS has several advantages over previous AMR systems: 1) standardized AMR data based on a strain-collection system, 2) characterization of multidrug-resistant clones by molecular epidemiologic evaluation, 3) collection of the clinical information related to bacterial isolates, and 4) an independent quality control center and the Kor-GLASS database. Based on a successful pilot program, the first phase of Kor-GLASS operated from 2017 to 2019, and the second phase (2020-2022) of the system is now underway. Kor-GLASS provides comprehensive AMR surveillance data, and the trends of AMR epidemiology are determined by molecular characterization. Furthermore, it enables a global comparison of AMR with that in other GLASS-enrolled countries owing to the harmonized platform. Kor-GLASS should be further improved to provide sustainable and reliable AMR data by establishing additional collecting centers for representativeness, covering community infection-associated AMR, and investigating emerging AMR.