Further increases in carbapenem-, amikacin-, and fluoroquinolone-resistant isolates of Acinetobacter spp. and P. aeruginosa in Korea: KONSAR study 2009

Kyungwon Lee; Mi-Na Kim; Jae-Seok Kim; Hye Lim Hong; Jung Oak Kang; Jong Hee Shin; Yeon-Joon Park; Dongeun Yong; Seok Hoon Jeong; Yunsop Chong; The KONSAR Group

doi:10.3349/ymj.2011.52.5.793

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Further increases in carbapenem-, amikacin-, and fluoroquinolone-resistant isolates of Acinetobacter spp. and P. aeruginosa in Korea: KONSAR study 2009

Authors: Kyungwon Lee ; Mi-Na Kim ; Jae-Seok Kim ; Hye Lim Hong ; Jung Oak Kang ; Jong Hee Shin ; Yeon-Joon Park ; Dongeun Yong ; Seok Hoon Jeong ; Yunsop Chong ; The KONSAR Group

Citation: YONSEI MEDICAL JOURNAL, Vol.52(5) : 793-802, 2011

Journal Title: YONSEI MEDICAL JOURNAL

ISSN: 0513-5796

Issue Date: 2011

MeSH: Acinetobacter/drug effects* ; Acinetobacter/isolation & purification ; Acinetobacter Infections/drug therapy ; Acinetobacter Infections/microbiology ; Amikacin/pharmacology ; Anti-Bacterial Agents/pharmacology ; Carbapenems/pharmacology ; Cross Infection/drug therapy ; Cross Infection/microbiology ; Drug Resistance, Bacterial* ; Fluoroquinolones/pharmacology ; Humans ; Pseudomonas Infections/drug therapy ; Pseudomonas Infections/microbiology ; Pseudomonas aeruginosa/drug effects* ; Pseudomonas aeruginosa/isolation & purification ; Republic of Korea

Keywords: Antimicrobial resistance surveillance ; fluoroquinolone resistance ; imipenem resistance ; KONSAR ; Staphylococcus ; Acinetobacter spp. ; P. aeruginosa

Abstract: 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-nonsusceptible 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