title: Results from the Survey of Antibiotic Resistance (SOAR) 2012-14 in Thailand, India, South Korea and Singapore.
abstract: OBJECTIVE
  To provide susceptibility data for community-acquired respiratory tract isolates of Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae and Moraxella catarrhalis collected in 2012-14 from four Asian countries.
  
  
  METHODS
  MICs were determined using Etest(®) for all antibiotics except erythromycin, which was evaluated by disc diffusion. Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. For macrolide/clindamycin interpretation, breakpoints were adjusted for incubation in CO2 where available.
  
  
  RESULTS
  Susceptibility of S. pneumoniae was generally lower in South Korea than in other countries. Penicillin susceptibility assessed using CLSI oral or EUCAST breakpoints ranged from 21.2% in South Korea to 63.8% in Singapore. In contrast, susceptibility using CLSI intravenous breakpoints was much higher, at 79% in South Korea and ∼95% or higher elsewhere. Macrolide susceptibility was ∼20% in South Korea and ∼50%-60% elsewhere. Among S. pyogenes isolates (India only), erythromycin susceptibility (∼20%) was lowest of the antibiotics tested. In H. influenzae antibiotic susceptibility was high except for ampicillin, where susceptibility ranged from 16.7% in South Korea to 91.1% in India. South Korea also had a high percentage (18.1%) of β-lactamase-negative ampicillin-resistant isolates. Amoxicillin/clavulanic acid susceptibility for each pathogen (PK/PD high dose) was between 93% and 100% in all countries except for H. influenzae in South Korea (62.5%).
  
  
  CONCLUSIONS
  Use of EUCAST versus CLSI breakpoints had profound differences for cefaclor, cefuroxime and ofloxacin, with EUCAST showing lower susceptibility. There was considerable variability in susceptibility among countries in the same region. Thus, continued surveillance is necessary to track future changes in antibiotic resistance.
authors.affiliation: GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK didem.x.torumkuney@gsk.com.
authors.forename: D
authors.initials: D
authors.lastname: Torumkuney
authors.affiliation: Faculty of Medicine, Chiang Mai University, Maharaj Nakorn Chiang Mai Hospital, 110 Intavaroros Road, Tambon Sribhoom, Muang, Chiang Mai 50200, Thailand.
authors.forename: R
authors.initials: R
authors.lastname: Chaiwarith
authors.affiliation: Khon Kaen University Faculty of Medicine, Srinagarind Hospital, 123 Mittraphap Highway, Tambol Naimuang, Muang District, Khon Kaen 40002, Thailand.
authors.forename: W
authors.initials: W
authors.lastname: Reechaipichitkul
authors.affiliation: Mahidol University Faculty of Medicine Ramathibodi Hospital, 270 Rama VI. Road, oong Phayathai, Ratchathewi, Bangkok 10400, Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Malatham
authors.affiliation: GlaxoSmithKline Thailand, 12th Floor, Wave Place, 55 Wireless Road, Lumpini, Patumwan, Bangkok 10330, Thailand.
authors.forename: V
authors.initials: V
authors.lastname: Chareonphaibul
authors.affiliation: Hinduja Hospital and Medical Research Centre, Department of Microbiology, Veer Savarkar Marg, Mahim, Mumbai 400 016, India.
authors.forename: C
authors.initials: C
authors.lastname: Rodrigues
authors.affiliation: Choithram Hospital and Research Centre, Department of Microbiology, Manik Bagh Road, Indore 452 014 (M/P), India.
authors.forename: D S
authors.initials: DS
authors.lastname: Chitins
authors.affiliation: St John's Medical College Hospital, Department of Microbiology, Sarjapur Road, Bangalore 560 034, India.
authors.forename: M
authors.initials: M
authors.lastname: Dias
authors.affiliation: Christian Medical College, Department of Microbiology, Vellore 632 004, India.
authors.forename: S
authors.initials: S
authors.lastname: Anandan
authors.affiliation: GlaxoSmithKline India, No. 5 Embassy Links, Cunningham (SRT) Road, Bangalore 560 052, India.
authors.forename: S
authors.initials: S
authors.lastname: Kanakapura
authors.affiliation: The Catholic University of Korea, Seoul St Mary's Hospital, 222 Banpo-daero, Seocho-Gu, Seoul, South Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Park
authors.affiliation: Yonsei University College of Medicine, Severance Hospital, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea.
authors.forename: K
authors.initials: K
authors.lastname: Lee
authors.affiliation: Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea.
authors.forename: H
authors.initials: H
authors.lastname: Lee
authors.affiliation: Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea.
authors.forename: J Y
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Hanyang University Medical Center, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, South Korea.
authors.forename: Y
authors.initials: Y
authors.lastname: Lee
authors.affiliation: The Catholic University of Korea, Uijongbu St Mary's Hospital, 271, Cheonbo-ro, Ukjeongbu-si, Gyeonggi-do, Korea.
authors.forename: H K
authors.initials: HK
authors.lastname: Lee
authors.affiliation: GlaxoSmithKline Korea, LS Yongsan Tower, 9th Floor, Hangang 191, Yongsan-gu, Seoul, South Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Changi General Hospital Pte Ltd (Reg. No. 198904226R), 2 Simei Street 3, Singapore 529889.
authors.forename: T Y
authors.initials: TY
authors.lastname: Tan
authors.affiliation: Changi General Hospital Pte Ltd (Reg. No. 198904226R), 2 Simei Street 3, Singapore 529889.
authors.forename: Y X
authors.initials: YX
authors.lastname: Heng
authors.affiliation: GlaxoSmithKline Singapore, (Reg. No. 198102938K), 150 Beach Road, No. 22-00 Gateway West, Singapore 189720.
authors.forename: P
authors.initials: P
authors.lastname: Mukherjee
authors.affiliation: IHMA Europe Sàrl, 9A Route de la Corniche, Epalinges 1066, Switzerland.
authors.forename: I
authors.initials: I
authors.lastname: Morrissey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001210:Asia, Southeastern / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D062665:Epidemiological Monitoring; D006193:Haemophilus influenzae / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D001936:Moraxella catarrhalis / Q000187:drug effects* / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D013291:Streptococcus / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents