The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Current status and future strategies of antimicrobial resistance in Korea

항생제 내성의 국내 현황 및 대책

Song, Jae-Hoon
송재훈

  • Published : 20090800
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Abstract

Antimicrobial resistance in major bacterial pathogens became a serious problem in the clinical practice. In Korean hospitals, prevalence rates of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE), and multidrug-resistant gram-negative bacilli are very high. In the community, macrolide-resistant Streptococcus pneumoniae and community-associated MRSA are major resistant pathogens. Infections caused by antimicrobial-resistant bacteria are associated with a greater likelihood of inappropriate antimicrobial therapy and poor clinical outcome. Physicians should have updated information and knowledge about current epidemiological status of resistance and appropriate use of antimicrobial agents. Appropriate use of antimicrobial agents, strict infection control, and development of new antibiotics and vaccines are important future strategies for the control of antimicrobial resistance. This review focuses on the current epidemiology and clinical implications of antimicrobial-resistant bacterial infections in Korea based on the published data for the past 10 years.

Keywords

References

  1. Kim JM, Park ES, Jeong JS, Kim KM, Kim JM, Oh HS, Yoon SW, Chang HS, Chang KH, Lee SI, Lee MS, Song JH, Kang MW, Park SC, Choe KW, Pai CH. Multicenter surveillance study for nosocomial infections in major hospitals in Korea. Nosocomial Infection Surveillance Committee of the Korean Society for Nosocomial Infection Control. Am J Infect Control 28:454-458, 2000 https://doi.org/10.1067/mic.2000.107592
  2. Fridkin SK, Hageman JC, Morrison M, Sanza LT, Como-Sabetti K, Jernigan JA, Harriman K, Harrison LH, Lynfield R, Farley MM. Methicillin-resistant Staphylococcus aureus disease in three communities. N Engl J Med 352:1436-1444, 2005 https://doi.org/10.1056/NEJMoa043252
  3. Kim ES, Song JS, Lee HJ, Choe PG, Park KH, Cho JH, Park WB, Kim SH, Bang JH, Kim DM, Park KU, Shin S, Lee MS, Choi HJ, Kim NJ, Kim EC, Oh MD, Kim HB, Choe KW. A survey of community-associated methicillin-resistant Staphylococcus aureus in Korea. J Antimicrob Chemother 60:1108-1114, 2007 https://doi.org/10.1093/jac/dkm309
  4. Blot SI, Vandewoude KH, Hoste EA, Colardyn FA. Outcome and attributable mortality in critically III patients with bacteremia involving methicillin-susceptible and methicillin-resistant Staphylococcus aureus. Arch Intern Med 162:2229-2235, 2002 https://doi.org/10.1001/archinte.162.19.2229
  5. Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y. Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis 36:53-59, 2003 https://doi.org/10.1086/345476
  6. Chang FY, MacDonald BB, Peacock JE Jr, Musher DM, Triplett P, Mylotte JM, O'Donnell A, Wagener MM, Yu VL. A prospective multicenter study of Staphylococcus aureus bacteremia: incidence of endocarditis, risk factors for mortality, and clinical impact of methicillin resistance. Medicine (Baltimore) 82:322-332, 2003 https://doi.org/10.1097/01.md.0000091185.93122.40
  7. Kluytmans J, Struelens M. Meticillin resistant Staphylococcus aureus in the hospital. BMJ 338:b364, 2009 https://doi.org/10.1136/bmj.b364
  8. Loeb M, Main C, Walker-Dilks C, Eady A. Antimicrobial drugs for treating methicillin-resistant Staphylococcus aureus colonization. Cochrane Database Syst Rev:CD003340, 2003 https://doi.org/10.1002/14651858.CD003340
  9. Schaffer AC, Lee JC. Vaccination and passive immunisation against Staphylococcus aureus. Int J Antimicrob Agents 32(Suppl 1):S71-S78, 2008 https://doi.org/10.1016/j.ijantimicag.2008.06.009
  10. Center for Disease Control and Prevention (CDC). Reduced susceptibility of Staphylococcus aureus to vancomycin: Japan, 1996. MMWR Morb Mortal Wkly Rep 46:624-626, 1997
  11. Appelbaum PC. The emergence of vancomycin-intermediate and vancomycin-resistant Staphylococcus aureus. Clin Microbiol Infect 12(Suppl 1):16-23, 2006
  12. Sievert DM, Rudrik JT, Patel JB, McDonald LC, Wilkins MJ, Hageman JC. Vancomycin-resistant Staphylococcus aureus in the United States, 2002-2006. Clin Infect Dis 46:668-674, 2008 https://doi.org/10.1086/527392
  13. Kim MN, Pai CH, Woo JH, Ryu JS, Hiramatsu K. Vancomycin-intermediate Staphylococcus aureus in Korea. J Clin Microbiol 38:3879-3881, 2000
  14. Hong KH, Park JS, Kim EC. Two cases of vancomycin-intermediate Staphylococcus aureus isolated from joint tissue or wound. Korean J Lab Med 28:444-448, 2008 https://doi.org/10.3343/kjlm.2008.28.6.444
  15. Sood S, Malhotra M, Das BK, Kapil A. Enterococcal infections & antimicrobial resistance. Indian J Med Res 128:111-121, 2008
  16. Koh EM, Lee SG, Kim CK, Kim M, Yong D, Lee K, Kim JM, Kim DS, Chong Y. Microorganisms isolated from blood cultures and their antimicrobial susceptibility patterns at a university hospital during 1994-2003. Korean J Lab Med 27:265-275, 2007 https://doi.org/10.3343/kjlm.2007.27.4.265
  17. Hong SG, Yong D, Lee K, Kim EC, Lee WK, Jeong SH, Song WK, Park YJ, Kim MN, Uh Y, Shin JH, Lee J, Ahn JY, Lee SW, Kim JS, Shin HB. Antimicrobial resistance of clinically important bacteria isolated from hospitals located in representative provinces of Korea. Korean J Clin Microbiol 6:29-36, 2003
  18. Hong SG, Lee J, Yong D, Kim EC, Jeong SH, Park YJ, Choi TY, Uh Y, Shin JH, Lee WK, Ahn JY, Lee SH, Woo GJ, Lee K. Antimicrobial resistance of clinically important bacteria isolated from 12 hospitals in Korea. Korean J Clin Microbiol 7:171-177, 2004
  19. Lee H, Kim CK, Lee J, Lee SH, Ahn JY, Hong SG, Park YJ, Jeong SH, Kim EC, Lee WK, Uh Y, Shin JH, Choi TY, Kwak H-S, Lee K. Antimicrobial resistance of clinically important bacteria isolated from 12 hospitals in Korea in 2005 and 2006. Korean J Clin Microbiol 10:59-67, 2007
  20. Lee K, Kim MY, Kang SH, Kang JO, Kim EC, Choi TY, Chong Y. Korean nationwide surveilance of antimicrobial resistance in 2000 with special reference to vancomycin resistance in enterococci, and expanded-spectrum cephalosporin and imipenem resistance in gram-negative bacilli. Yonsei Med J 44:571-578, 2003 https://doi.org/10.3349/ymj.2003.44.4.571
  21. Han SH, Chin BS, Lee HS, Jeong SJ, Choi HK, Kim CO, Yong D, Choi JY, Song YG, Lee K, Kim JM. Vancomycin-resistant enterococci bacteremia: risk factors for mortality and influence of antimicrobial therapy on clinical outcome. J Infect 58:182-190, 2009 https://doi.org/10.1016/j.jinf.2009.01.013
  22. Linden PK. Optimizing therapy for vancomycin-resistant enterococci (VRE). Semin Respir Crit Care Med 28:632-645, 2007 https://doi.org/10.1055/s-2007-996410
  23. Kauffman CA. Therapeutic and preventative options for the management of vancomycin-resistant enterococcal infections. J Antimicrob Chemother 51(Suppl 3):iii23-iii30, 2003
  24. Torres-Viera C, Dembry LM. Approaches to vancomycin-resistant enterococci. Curr Opin Infect Dis 17:541-547, 2004 https://doi.org/10.1097/00001432-200412000-00006
  25. Lynch JP 3rd, Zhanel GG. Streptococcus pneumoniae: does antimicrobial resistance matter? Semin Respir Crit Care Med 30: 210-238, 2009 https://doi.org/10.1055/s-0029-1202939
  26. Jackson LA, Janoff EN. Pneumococcal vaccination of elderly adults: new paradigms for protection. Clin Infect Dis 47:1328- 1338, 2008 https://doi.org/10.1086/592691
  27. Center for Disease Control and PRevention (CDC). Progress in introduction of pneumococcal conjugate vaccine: worldwide, 2000-2008. MMWR Morb Mortal Wkly Rep 57:1148-1151, 2008
  28. Advisory Committee on Immunization Practices (ACIP). Preventing pneumococcal disease among infants and young children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 49:1-35, 2000
  29. Advisory Committee on Immunization Practices (ACIP). Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 46:1-24, 1997
  30. Cordonnier C, Labopin M, Chesnel V, Ribaud P, De La Camara R, Martino R, Ullmann AJ, Parkkali T, Locasciulli A, Yakouben K, Pauksens K, Einsele H, Niederwieser D, Apperley J, Ljungman P. Randomized study of early versus late immunization with pneumococcal conjugate vaccine after allogeneic stem cell transplantation. Clin Infect Dis 48:1392-1401, 2009 https://doi.org/10.1086/598324
  31. de Roux A, Schmole-Thoma B, Siber GR, Hackell JG, Kuhnke A, Ahlers N, Baker SA, Razmpour A, Emini EA, Fernsten PD, Gruber WC, Lockhart S, Burkhardt O, Welte T, Lode HM. Comparison of pneumococcal conjugate polysaccharide and free polysaccharide vaccines in elderly adults: conjugate vaccine elicits improved antibacterial immune responses and immunological memory. Clin Infect Dis 46:1015-1023, 2008 https://doi.org/10.1086/529142
  32. Jackson LA, Neuzil KM, Nahm MH, Whitney CG, Yu O, Nelson JC, Starkovich PT, Dunstan M, Carste B, Shay DK, Baggs J, Carlone GM. Immunogenicity of varying dosages of 7-valent pneumococcal polysaccharide-protein conjugate vaccine in seniors previously vaccinated with 23-valent pneumococcal polysaccharide vaccine. Vaccine 25:4029-4037, 2007 https://doi.org/10.1016/j.vaccine.2007.02.062
  33. Kumar D, Welsh B, Siegal D, Chen MH, Humar A. Immunogenicity of pneumococcal vaccine in renal transplant recipients: three year follow-up of a randomized trial. Am J Transplant 7:633-638, 2007 https://doi.org/10.1111/j.1600-6143.2007.01668.x
  34. Lee K, Lim CH, Cho JH, Lee WG, Uh Y, Kim HJ, Yong D, Chong Y. High prevalence of ceftazidime-resistant Klebsiella pneumoniae and increase of imipenem-resistant Pseudomonas aeruginosa and Acinetobacter spp. in Korea: a KONSAR program in 2004. Yonsei Med J 47:634-645, 2006 https://doi.org/10.3349/ymj.2006.47.5.634
  35. Kang CI, Kim SH, Kim DM, Park WB, Lee KD, Kim HB, Oh MD, Kim EC, Choe KW. Risk factors for and clinical outcomes of bloodstream infections caused by extended-spectrum beta-lactamase- producing Klebsiella pneumoniae. Infect Control Hosp Epidemiol 25:860-867, 2004 https://doi.org/10.1086/502310
  36. Kim BN, Woo JH, Kim MN, Ryu J, Kim YS. Clinical implications of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae bacteraemia. J Hosp Infect 52:99-106, 2002 https://doi.org/10.1053/jhin.2002.1288
  37. Kim YK, Pai H, Lee HJ, Park SE, Choi EH, Kim J, Kim JH, Kim EC. Bloodstream infections by extended-spectrum beta-lactamase- producing Escherichia coli and Klebsiella pneumoniae in children: epidemiology and clinical outcome. Antimicrob Agents Chemother 46:1481-1491, 2002 https://doi.org/10.1128/AAC.46.5.1481-1491.2002
  38. Kang CI, Kim SH, Park WB, Lee KD, Kim HB, Kim EC, Oh MD, Choe KW. Bloodstream infections due to extended-spectrum beta- lactamase-producing Escherichia coli and Klebsiella pneumoniae: risk factors for mortality and treatment outcome, with special emphasis on antimicrobial therapy. Antimicrob Agents Chemother 48:4574-4581, 2004 https://doi.org/10.1128/AAC.48.12.4574-4581.2004
  39. MacGowan A. Breakpoints for extended-spectrum beta-lactamase- producing Enterobacteriacae: pharmacokinetic/pharmacodynamic considerations. Clin Microbiol Infect 14 Suppl 1:166- 168, 2008 https://doi.org/10.1111/j.1469-0691.2007.01859.x
  40. Gavin PJ, Suseno MT, Thomson RB Jr, Gaydos JM, Pierson CL, Halstead DC, Aslanzadeh J, Brecher S, Rotstein C, Brossette SE, Peterson LR. Clinical correlation of the CLSI susceptibility breakpoint for piperacillin- tazobactam against extended-spectrum-betalactamase- producing Escherichia coli and Klebsiella species. Antimicrob Agents Chemother 50:2244-2247, 2006 https://doi.org/10.1128/AAC.00381-05
  41. Lee CH, Su LH, Tang YF, Liu JW. Treatment of ESBL-producing Klebsiella pneumoniae bacteraemia with carbapenems or flomoxef: a retrospective study and laboratory analysis of the isolates. J Antimicrob Chemother 58:1074-1077, 2006 https://doi.org/10.1093/jac/dkl381
  42. Livermore DM, Hope R, Fagan EJ, Warner M, Woodford N, Potz N. Activity of temocillin against prevalent ESBL- and AmpC-producing Enterobacteriaceae from south-east England. J Antimicrob Chemother 57:1012-1014, 2006 https://doi.org/10.1093/jac/dkl043
  43. Lee HJ, Yoon HB, Han SS, Cha R, Oh KH, Joo KW, Park SW, Lim CS, Oh YK. Causative organisms and antibiotics sensitivity in community acquired acute oyelonephritis. Korean J Nephrol 27:688-695, 2008
  44. Garau J. Other antimicrobials of interest in the era of extended- spectrum beta-lactamases: fosfomycin, nitrofurantoin and tigecycline. Clin Microbiol Infect 14(Suppl 1):198-202, 2008 https://doi.org/10.1111/j.1469-0691.2007.01852.x
  45. Lee K, Lee HS, Jang SJ, Park AJ, Lee MH, Song WK, Chong YS. Antimicrobial resistance surveillance of bacteria in 1999 in Korea with a special reference to resistance of Enterococci to vancomycin and gram-negative bacilli to third generation cephalosporin, imipenem, and fluoroquinolone. J Korean Med Sci 16:262-270, 2001 https://doi.org/10.3346/jkms.2001.16.3.262
  46. Lee K, Jang SJ, Lee HJ, Ryoo N, Kim M, Hong SG, Chong Y. Increasing prevalence of vancomycin-resistant Enterococcus faecium, expanded-spectrum cephalosporin-resistant Klebsiella pneumoniae, and imipenem-resistant Pseudomonas aeruginosa in Korea: KONSAR study in 2001. J Korean Med Sci 19:8-14, 2004 https://doi.org/10.3346/jkms.2004.19.1.8
  47. Hong SG, Yong D, Lee K, Kim EC, Lee WK, Jeong SH, Song WK, Park YJ, Kim MN, Uh Y, Shin JH, Lee J, Ahn JY, Lee SW, Kim JS, Shin HB. Antimicrobial resistance of clinically important bacteria isolated from hospitals located in representative provinces of Korea. Korean J Clin Microbiol 6:29-36, 2003
  48. Lee K, Park KH, Jeong SH, Lim HS, Shin JH, Yong D, Ha GY, Chong Y. Further increase of vancomycin-resistant Enterococcus faecium, amikacin- and fluoroquinolone-resistant Klebsiella pneumoniae, and imipenem-resistant acinetobacter spp. in Korea: 2003 KONSAR surveillance. Yonsei Med J 47:43-54, 2006 https://doi.org/10.3349/ymj.2006.47.1.43
  49. Lee K, Lim CH, Cho JH, Lee WG, Uh Y, Kim HJ, Yong D, Chong Y. High prevalence of ceftazidime-resistant Klebsiella pneumoniae and increase of imipenem-resistant Pseudomonas aeruginosa and acinetobacter spp. in Korea: a KONSAR Program in 2004. Yonsei Med J 47:634-645, 2006 https://doi.org/10.3349/ymj.2006.47.5.634
  50. Lee H, Kim CK, Lee J, Lee SH, Ahn JY, Hong SG, Park YJ, Jeong SH, Kim EC, Lee WK, Uh Y, Shin JH, Choi TY, Kwak HS, Lee K. Antimicrobial resistance of clinically important bacteria isolated from 12 hospitals in Korea in 2005 and 2006. Korean J Clin Microbiol 10:59-69, 2007
  51. Song W, Lee TJ, Park MJ, Kim HS, Kim JS, Woo HJ, Lee KM. Susceptibility of clinical isolates of acinetobacter baumannii and Pseudomonas aeruginosa to colistin and polymyxin B in Korea. Infect Chemother 38:362-366, 2006
  52. Yoon J, Moon H, Lee M. In vitro activity of antimicrobial combination against multidrug-resistant Pseudomonas aeruginosa, Korea. Korean J Clin Microbiol 9:1-6, 2006
  53. Jean SS, Hsueh PR, Lee WS, Chang HT, Chou MY, Chen IS, Wang JH, Lin CF, Shyr JM, Ko WC, Wu JJ, Liu YC, Huang WK, Teng LJ, Liu CY. Nationwide surveillance of antimicrobial resistance among non-fermentative Gram-negative bacteria in Intensive Care Units in Taiwan: SMART programme data 2005. Int J Antimicrob Agents 33:266-271, 2009 https://doi.org/10.1016/j.ijantimicag.2008.08.026
  54. Yoo J, Sohn ES, Chung GT, Lee EH, Lee KR, Park YK, Lee YS. Five-year report of national surveillance of antimicrobial resistance in Pseudomonas aeruginosa isolated from non-tertiary care hospitals in Korea (2002-2006). Diagn Microbiol Infect Dis 60:291-294, 2008 https://doi.org/10.1016/j.diagmicrobio.2007.10.005
  55. Kang CI, Kim SH, Park WB, Lee KD, Kim HB, Kim EC, Oh MD, Choe KW. Risk factors for antimicrobial resistance and influence of resistance on mortality in patients with bloodstream infection caused by Pseudomonas aeruginosa. Microb Drug Resist 11:68- 74, 2005 https://doi.org/10.1089/mdr.2005.11.68
  56. Paul M, Leibovici L. Combination antimicrobial treatment versus monotherapy: the contribution of meta-analyses. Infect Dis Clin North Am 23:277-293, 2009 https://doi.org/10.1016/j.idc.2009.01.004
  57. Montero M, Horcajada JP, Sorli L, Alvarez-Lerma F, Grau S, Riu M, Sala M, Knobel H. Effectiveness and safety of colistin for the treatment of multidrug-resistant Pseudomonas aeruginosa Infections. Infection 2009 [Epub ahead of print] https://doi.org/10.1007/s15010-009-8342-x
  58. Chong Y, Lee K. Present situation of antimicrobial resistance in Korea. J Infect Chemother 6:189-195, 2000 https://doi.org/10.1007/s101560070001
  59. Kwon KT, Oh WS, Song JH, Chang HH, Jung SI, Kim SW, Ryu SY, Heo ST, Jung DS, Rhee JY, Shin SY, Ko KS, Peck KR, Lee NY. Impact of imipenem resistance on mortality in patients with Acinetobacter bacteraemia. J Antimicrob Chemother 59:525-530, 2007 https://doi.org/10.1093/jac/dkl499
  60. Petrosillo N, Ioannidou E, Falagas ME. Colistin monotherapy vs. combination therapy: evidence from microbiological, animal and clinical studies. Clin Microbiol Infect 14:816-827, 2008 https://doi.org/10.1111/j.1469-0691.2008.02061.x
  61. Karageorgopoulos DE, Kelesidis T, Kelesidis I, Falagas ME. Tigecycline for the treatment of multidrug-resistant (including carbapenem-resistant) Acinetobacter infections: a review of the scientific evidence. J Antimicrob Chemother 62:45-55, 2008 https://doi.org/10.1093/jac/dkn165
  62. Yoo BW, Kang JW, Kim ST, Oh JE, Hong SH, Cho CY. An analysis of outpatient prescription before and after the implementation of the medical reform in an university hospital. J Korean Acad Fam Med 23:855-868, 2002
  63. Health Insurance Review & Assessment Service. Results of a drug assessment, pursuit and management, 3/4, 2008. 2008
  64. Jung SI, Park KH, Kwon KT, Ko KS, Oh WS, Chung DR, Peck KR, Yeom JS, Chang HH, Kim SW, Son JS, Song JH. Relationship between beta-lactam antimicrobial use and antimicrobial resistance in Klebsiella pneumoniae clinical isolates at 5 tertiary hospitals in Korea. Infect Chemother 39:189-195, 2007
  65. Yoon YK, Kim MJ, Sohn JW, Park DW, Kim JY, Chun BC. Surveillance of antimicrobial use and antimicrobial resistance. Infect Chemother 40:93-101, 2008 https://doi.org/10.3947/ic.2008.40.2.93