Epidemiology and treatment of antimicrobialresistant gram-negative bacteria in Korea

Kim, Young Ah; Park, Yoon Soo

doi:10.3904/kjim.2018.028

Cited by 26 publications

(26 citation statements)

References 47 publications

(62 reference statements)

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“…Similar trends were observed among K. pneumoniae isolates, although there were relatively low isolate numbers in the resistant subsets for this species. Studies of antimicrobial resistance in South Korea and Taiwan, on isolates collected between 2012 and 2017, have reported the rates of amikacin resistance to be < 10% among E. coli and K. pneumoniae isolates [20][21][22], and among carbapenemnonsusceptible E. coli isolates (Taiwan only) [23].…”

Section: Discussionmentioning

confidence: 99%

In vitro activity of ceftazidime–avibactam and comparators against Gram-negative bacterial isolates collected in the Asia–Pacific region as part of the INFORM program (2015–2017)

Stone

2020

Ann Clin Microbiol Antimicrob

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Background: Antimicrobial resistance among nosocomial Gram-negative pathogens is a cause for concern in the Asia-Pacific region. The aims of this study were to measure the rates of resistance among clinical isolates collected in Asia-Pacific countries, and to determine the in vitro antimicrobial activities of ceftazidime-avibactam and comparators against these isolates. Methods: CLSI broth microdilution methodology was used to determine antimicrobial activity and EUCAST breakpoints version 9.0 were used to determine rates of susceptibility and resistance. Isolates were also screened for the genes encoding extended-spectrum β-lactamases (ESBLs) or carbapenemases (including metallo-β-lactamases [MBLs]). Results: Between 2015 and 2017, this study collected a total of 7051 Enterobacterales isolates and 2032 Pseudomonas aeruginosa isolates from hospitalized patients in Australia, Japan, South Korea, Malaysia, the Philippines, Taiwan, and Thailand. In the Asia-Pacific region, Enterobacterales isolates that were ESBL-positive, carbapenemase-negative (17.9%) were more frequently identified than isolates that were carbapenemase-positive, MBL-negative (0.7%) or carbapenemase-positive, MBL-positive (1.7%). Multidrug-resistant (MDR) isolates of P. aeruginosa were more commonly identified (23.4%) than isolates that were ESBL-positive, carbapenemase-negative (0.4%), or carbapenemasepositive, MBL-negative (0.3%), or carbapenemase-positive, MBL-positive (3.7%). More than 90% of all Enterobacterales isolates, including the ESBL-positive, carbapenemase-negative subset and the carbapenemase-positive, MBL-negative subset, were susceptible to amikacin and ceftazidime-avibactam. Among the carbapenemase-positive, MBL-positive subset of Enterobacterales, susceptibility to the majority of agents was reduced, with the exception of colistin (93.4%). Tigecycline was active against all resistant subsets of the Enterobacterales (MIC 90 , 1-4 mg/L) and among Escherichia coli isolates, > 90% from each resistant subset were susceptible to tigecycline. More than 99% of all P. aeruginosa isolates, including MDR isolates and the carbapenemase-positive, MBL-positive subset, were susceptible to colistin.

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Section: Discussionmentioning

confidence: 99%

In vitro activity of ceftazidime–avibactam and comparators against Gram-negative bacterial isolates collected in the Asia–Pacific region as part of the INFORM program (2015–2017)

Stone

2020

Ann Clin Microbiol Antimicrob

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“…In particular, the prevalence of carbapenem-resistant A. baumannii (CRAB) isolates is on the rise in Asian countries, including South Korea [3,4]. The specific clone, international clone 2 (IC II), is a major clonal group among Korean CRAB isolates [5]. This organism is associated with nosocomial outbreaks and multidrug resistance in association with bla OXA-23-like genes [6].…”

Section: Introductionmentioning

confidence: 99%

Using comparative genomics to understand molecular features of carbapenem-resistant Acinetobacter baumannii from South Korea causing invasive infections and their clinical implications

et al. 2020

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Acinetobacter baumannii is a highly potent nosocomial pathogen that is associated with increased in-hospital mortality. Here, we investigated the changes in molecular characteristics of carbapenem-resistant A. baumannii (CRAB) isolated from the blood samples of patients admitted to a tertiary hospital in South Korea from January 2009 to July 2015. Whole genome sequencing using the Illumina MiSeq platform and multi-locus sequence typing (MLST) were performed for 98 CRAB clinical isolates. In silico analyses for the prediction of antimicrobial resistance and virulence factor genes were performed. Plasmid sequences, including complete forms, were reconstructed from the sequence reads. Epidemiologic data were collected from the hospital database. MLST using the Oxford scheme revealed 10 sequence types of CRAB, of which ST191 was the dominant type (n = 59). Although bla OXA-23 was shared by most analysed strains, the compositions of antimicrobial resistance determinants differed among sequence types. ST447 and ST451/ST1809 with a few resistance genes were isolated during the later years of the study period. The number of virulence genes increased, while that of ST191 did not change significantly over the investigation period. Intriguingly MLST types, compositions of antimicrobial resistance genes, and virulence genes had no association with clinical outcomes of CRAB bacteraemia. In conclusion, active changes in or accumulations of antimicrobial resistance determinants and virulence genes in CRAB were not observed during the research period. Molecular characteristics of CRAB had no association with clinical outcomes of CRAB bacteraemia.

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“…Carbapenemases are usually classified into three classes of β-lactamases (according to their amino acid identity): Ambler class A (serine-β-lactamases), B (metallo-β-lactamases; MBLs), and D (oxacillinases; OXAs) β-lactamases. In addition, Ambler Class C β-lactamase (AmpC β-lactamase) could induce resistance to carbapenems in bacterial hosts, when accompanied with additional resistance mechanisms such as porin loss [111213].…”

Section: Introductionmentioning

confidence: 99%

Performance Evaluation of the Newly Developed BD Phoenix NMIC-500 Panel Using Clinical Isolates of Gram-Negative Bacilli

et al. 2019

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Background The emergence of carbapenem resistance among gram-negative bacilli (GNB), mediated by carbapenemase production, has necessitated the development of a simple and accurate device for detecting minimum inhibitory concentrations (MICs) and resistance mechanisms, especially carbapenemase production. We evaluated the performance of the BD Phoenix NMIC-500 panel (BD Diagnostic Systems, Sparks, MD, USA) for antimicrobial susceptibility testing (AST) and carbapenemase-producing organism (CPO) detection. Methods We used 450 non-duplicate clinical GNB isolates from six general hospitals in Korea (409 Enterobacteriaceae and 41 glucose non-fermenting bacilli [GNFB] isolates). AST for meropenem, imipenem, ertapenem, ceftazidime, and ceftazidime/avibactam, and CPO detection were performed using the Phoenix NMIC-500 panel. Broth microdilution was used as the reference method for AST. The rates of categorical agreement (CA), essential agreement (EA), minor error (mE), major error (ME), and very major error (VME) were calculated in each antimicrobial. In addition, PCR and sequencing were performed to evaluate the accuracy of CPO detection by the BD Phoenix NMIC-500 panel, and the rate of correct identification was calculated. Results The CA rates were >90% for all antimicrobials tested with the Enterobacteriaceae isolates, except for imipenem (87.2%). The GNFB CA rates ranged from 92.7% to 100% for all antimicrobials. The ME rates were 1.7% for Enterobacteriaceae and 0% for GNFB. The panel identified 97.2% (243/250) of the carbapenemase-producing isolates. Conclusions The BD Phoenix NMIC-500 panel shows promise for AST and CPO detection.

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Epidemiology and treatment of antimicrobialresistant gram-negative bacteria in Korea

Cited by 26 publications

References 47 publications

In vitro activity of ceftazidime–avibactam and comparators against Gram-negative bacterial isolates collected in the Asia–Pacific region as part of the INFORM program (2015–2017)

In vitro activity of ceftazidime–avibactam and comparators against Gram-negative bacterial isolates collected in the Asia–Pacific region as part of the INFORM program (2015–2017)

Using comparative genomics to understand molecular features of carbapenem-resistant Acinetobacter baumannii from South Korea causing invasive infections and their clinical implications

Performance Evaluation of the Newly Developed BD Phoenix NMIC-500 Panel Using Clinical Isolates of Gram-Negative Bacilli

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