Major Bloodstream Infection-Causing Bacterial Pathogens and Their Antimicrobial Resistance in South Korea, 2017-2019: Phase I Report From Kor-GLASS

Dokyun Kim; Eun-Jeong Yoon; Jun Sung Hong; Min Hyuk Choi; Hyun Soo Kim; Young Ree Kim; Young Ah Kim; Young Uh; Kyeong Seob Shin; Jeong Hwan Shin; Jeong Su Park; Kyoung Un Park; Eun Jeong Won; Soo Hyun Kim; Jong Hee Shin; Jung Wook Kim; SungYoung Lee; Seok Hoon Jeong

doi:10.3389/fmicb.2021.799084

Major Bloodstream Infection-Causing Bacterial Pathogens and Their Antimicrobial Resistance in South Korea, 2017-2019: Phase I Report From Kor-GLASS

Front Microbiol. 2022 Jan 6:12:799084. doi: 10.3389/fmicb.2021.799084. eCollection 2021.

Authors

Dokyun Kim¹, Eun-Jeong Yoon^{1

2}, Jun Sung Hong¹, Min Hyuk Choi¹, Hyun Soo Kim³, Young Ree Kim⁴, Young Ah Kim⁵, Young Uh⁶, Kyeong Seob Shin⁷, Jeong Hwan Shin⁸, Jeong Su Park⁹, Kyoung Un Park⁹, Eun Jeong Won¹⁰, Soo Hyun Kim¹⁰, Jong Hee Shin¹⁰, Jung Wook Kim², SungYoung Lee², Seok Hoon Jeong¹

Affiliations

¹ Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea.
² National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, South Korea.
³ Department of Laboratory Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea.
⁴ Department of Laboratory Medicine, Jeju National University School of Medicine, Jeju, South Korea.
⁵ Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, South Korea.
⁶ Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
⁷ Department of Laboratory Medicine, College of Medicine, Chungbuk National University, Cheongju, South Korea.
⁸ Department of Laboratory Medicine and Paik Institute for Clinical Research, Inje University College of Medicine, Busan, South Korea.
⁹ Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
¹⁰ Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea.

Abstract

To monitor national antimicrobial resistance (AMR), the Korea Global AMR Surveillance System (Kor-GLASS) was established. This study analyzed bloodstream infection (BSI) cases from Kor-GLASS phase I from January 2017 to December 2019. Nine non-duplicated Kor-GLASS target pathogens, including Staphylococcus aureus, Enterococcus faecalis, Enterococcus faecium, Streptococcus pneumoniae, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp., and Salmonella spp., were isolated from blood specimens from eight sentinel hospitals. Antimicrobial susceptibility testing, AMR genotyping, and strain typing were carried out. Among the 20,041 BSI cases, 15,171 cases were caused by one of the target pathogens, and 12,578 blood isolates were collected for the study. Half (1,059/2,134) of S. aureus isolates were resistant to cefoxitin, and 38.1% (333/873) of E. faecium isolates were resistant to vancomycin. Beta-lactamase-non-producing ampicillin-resistant and penicillin-resistant E. faecalis isolates by disk diffusion method were identified, but the isolates were confirmed as ampicillin-susceptible by broth microdilution method. Among E. coli, an increasing number of isolates carried the bla _CTX-M-27 gene, and the ertapenem resistance in 1.4% (30/2,110) of K. pneumoniae isolates was mostly (23/30) conferred by K. pneumoniae carbapenemases. A quarter (108/488) of P. aeruginosa isolates were resistant to meropenem, and 30.5% (33/108) of those carried acquired carbapenemase genes. Over 90% (542/599) of A. baumannii isolates were imipenem-resistant, and all except one harbored the bla _OXA-23 gene. Kor-GLASS provided comprehensive AMR surveillance data, and the defined molecular mechanisms of resistance helped us to better understand AMR epidemiology. Comparative analysis with other GLASS-enrolled countries is possible owing to the harmonized system provided by GLASS.

Keywords: GLASS; Kor-GLASS; WHO; antimicrobial resistance; surveillance.