Increasing prevalence of vancomycin-resistant enterococci, and cefoxitin-, imipenem- and fluoroquinolone-resistant gram-negative bacilli: a KONSAR study in 2002.
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.
Lee
Kyungwon
K
Department of Laboratory Medicine, Research Institute of Bacterial Resistance, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
Kim
Young Ah
YA
Park
Yeon Joon
YJ
Lee
Hye Soo
HS
Kim
Moon Yeun
MY
Kim
Eui Chong
EC
Yong
Dongeun
D
Chong
Yunsop
Y
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002440:Cefoxitin / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D016983:Enterococcus / Q000187:drug effects*; D024841:Fluoroquinolones / Q000627:therapeutic use; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007723:Korea / Q000453:epidemiology; D015995:Prevalence; D020713:Vancomycin Resistance
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D002440:Cefoxitin; D015378:Imipenem