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Increasing prevalence of vancomycin-resistant enterococci, and cefoxitin-, imipenem- and fluoroquinolone-resistant
Kyungwon Lee1, Young Ah Kim, Yeon Joon Park
1Department of Laboratory Medicine, Research Institute of Bacterial Resistance, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
Abstract:
Continued antimicrobial resistance surveillance can provide valuable information for the empirical selection of antimicrobial agents for patient treatment, and for resistance control. In this 6th annual study for 2002, the susceptibility data at 39 Korean Nationwide Surveillance of Antimicrobial Resistance (KONSAR) hospitals were analyzed. Resistance rates of S. aureus were 67% to oxacillin, and 58% to clindamycin. The ampicillin and vancomycin resistance rates of E. faecium were 89% and 16%, respectively. To penicillin, 71% of S. pneumoniae were nonsusceptible. Resistance rates of E. coli were 11% to cefotaxime, 8% to cefoxitin, and 34% to fluoroquinolone, and those of K. pneumoniae were 22% to ceftazidime, and 16% to cefoxitin. Lowest resistance rates to cephalosporins shown by E. cloacae and S. marcescens were to cefepime, 7% and 17%, respectively. This is the first KONSAR surveillance, which detected imipenem-resistant E. coli and K. pneumoniae. To imipenem, 22% of P. aeruginosa and 9% of Acinetobacter spp. were resistant. Trends of resistances showed a slight reduction in MRSA and in penicillin- nonsusceptible S. pneumoniae, but an increase in ampicillin-resistant E. faecium. Ampicillin-resistant E. coli and H. influenzae remained prevalent. Compared to the previous study, amikacin- and fluoroquinolone- resistant Acinetobacter spp. increased to 60% and 62%, respectively. Ceftazidime- resistant K. pneumoniae decreased slightly, and imipenem- resistant P. aeruginosa and Acinetobacter spp., and vancomycin-resistant E. faecium increased. In conclusion, vancomycin-resistant E. faecium, cefoxitin-resistant E. coli and K. pneumoniae, and imipenem-resistant P. aeruginosa and Acinetobacter spp. increased gradually, and imipenem- resistant E. coli and K. pneumoniae appeared for the first time. Continued surveillance is required to prevent further spread of these serious resistances.
Insights
Antimicrobial resistance surveillance in Korea revealed rising rates of vancomycin-resistant Enterococcus faecium and imipenem-resistant bacteria. Continued monitoring is crucial to combat the spread of these serious antimicrobial resistances.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health Surveillance
Background:
- Antimicrobial resistance (AMR) surveillance is vital for guiding empirical antimicrobial therapy and resistance control strategies.
- The Korean Nationwide Surveillance of Antimicrobial Resistance (KONSAR) program monitors AMR trends across multiple hospitals.
- Understanding current resistance patterns is essential for effective patient treatment and public health.
Purpose of the Study:
- To analyze antimicrobial susceptibility data from 39 KONSAR hospitals in 2002.
- To identify trends in resistance rates for key bacterial pathogens.
- To report the emergence of new resistance mechanisms, such as imipenem resistance in E. coli and K. pneumoniae.
Main Methods:
- Analysis of susceptibility data collected from 39 hospitals participating in the KONSAR study in 2002.
- Evaluation of resistance rates for various bacterial species including S. aureus, E. faecium, S. pneumoniae, E. coli, K. pneumoniae, E. cloacae, S. marcescens, P. aeruginosa, and Acinetobacter spp.
- Comparison of resistance trends with previous surveillance periods.
Main Results:
- High resistance rates were observed: S. aureus (67% to oxacillin, 58% to clindamycin), E. faecium (89% to ampicillin, 16% to vancomycin), S. pneumoniae (71% nonsusceptible to penicillin).
- Emergence of imipenem-resistant E. coli and K. pneumoniae was detected for the first time. Resistance to imipenem was also noted in P. aeruginosa (22%) and Acinetobacter spp. (9%).
- Increasing trends in vancomycin-resistant E. faecium, cefoxitin-resistant E. coli and K. pneumoniae, and imipenem-resistant P. aeruginosa and Acinetobacter spp. were observed.
Conclusions:
- The study highlights a gradual increase in resistance to critical antibiotics like vancomycin and imipenem.
- The emergence of imipenem-resistant E. coli and K. pneumoniae signifies a concerning development in antimicrobial resistance.
- Continued KONSAR surveillance is imperative to monitor and mitigate the spread of these significant antimicrobial resistances.
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