Abstract
The continuous emergence of new antimicrobial resistance in major human pathogens is a serious threat to clinical medicine, that increases mortality, morbidity, length of hospitalization, and the cost of healthcare. This review article focuses on the current status of antimicrobial resistance and future strategies to overcome antimicrobial resistance. In the community, multidrugresistant Streptococcus pneumoniae, community-associated methicillin-resistant Staphylococcus aureus (MRSA), and extended-spectrum β-lactamaseproducing Enterobacteriaceae are major issues. In the hospital, an increasing prevalence of multidrug-resistant or pan-drug resistant gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii are emerging problems, while MRSA still remains the major cause of nosocomial infections. Strategies to control antimicrobial resistance include effective antimicrobial treatment, vaccination, infection control and appropriate policies and regulations. Continuous surveillance activities both in Korea and in an international setting are essential. Control of antimicrobial resistance should be a national priority based on a multisectoral approach, and international collaboration.
References
1. Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, Chaudhary U, Doumith M, Giske CG, Irfan S, Krishnan P, Kumar AV, Maharjan S, Mushtaq S, Noorie T, Paterson DL, Pearson A, Perry C, Pike R, Rao B, Ray U, Sarma JB, Sharma M, Sheridan E, Thirunarayan MA, Turton J, Upadhyay S, Warner M, Welfare W, Livermore DM, Woodford N. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis. 2010. 10:597–602.
2. Boucher HW, Talbot GH, Bradley JS, Edwards JE, Gilbert D, Rice LB, Scheld M, Spellberg B, Bartlett J. Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America. Clin Infect Dis. 2009. 48:1–12.
3. Song JH, Jung SI, Ki HK, Shin MH, Ko KS, Son JS, Chang HH, Kim SW, Lee H, Kim YS, Oh WS, Peck KR, Chongthaleong A, Lalitha MK, Perera J, Yee TT, Jamal F, Kamarulzaman A, Carlos CC, So T. Asian Network for Surveillance of Resistant Pathogens Study Group. Clinical outcomes of pneumococcal pneumonia caused by antibiotic-resistant strains in asian countries: a study by the Asian Network for Surveillance of Resistant Pathogens. Clin Infect Dis. 2004. 38:1570–1578.
4. Song JH, Chang HH, Suh JY, Ko KS, Jung SI, Oh WS, Peck KR, Lee NY, Yang Y, Chongthaleong A, Aswapokee N, Chiu CH, Lalitha MK, Perera J, Yee TT, Kumararasinghe G, Jamal F, Kamarulazaman A, Parasakthi N, Van PH, So T, Ng TK. ANSORP Study Group. Macrolide resistance and genotypic characterization of Streptococcus pneumoniae in Asian countries: a study of the Asian Network for Surveillance of Resistant Pathogens (ANSORP). J Antimicrob Chemother. 2004. 53:457–463.
5. Inoue M, Farrell DJ, Kaneko K, Akizawa K, Fujita S, Kaku M, Igari J, Yamaguchi K, Yamanaka K, Murase M, Asari S, Hirakata Y, Baba H, Itaha H. Antimicrobial susceptibility of respiratory tract pathogens in Japan during PROTEKT years 1-5 (1999-2004). Microb Drug Resist. 2008. 14:109–117.
6. Fridkin SK, Hageman JC, Morrison M, Sanza LT, Como-Sabetti K, Jernigan JA, Harriman K, Harrison LH, Lynfield R, Farley MM. Active Bacterial Core Surveillance Program of the Emerging Infections Program Network. Methicillin-resistant Staphylococcus aureus disease in three communities. N Engl J Med. 2005. 352:1436–1444.
7. Naimi TS, LeDell KH, Como-Sabetti K, Borchardt SM, Boxrud DJ, Etienne J, Johnson SK, Vandenesch F, Fridkin S, O'Boyle C, Danila RN, Lynfield R. Comparison of community -and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA. 2003. 290:2976–2984.
8. 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. 2007. 60:1108–1114.
9. Lee K, Lim CH, Cho JH, Lee WG, Uh Y, Kim HJ, Yong D, Chong Y. KONSAR Group. 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. 2006. 47:634–645.
10. Rodriguez-Bano J, Alcala JC, Cisneros JM, Grill F, Oliver A, Horcajada JP, Tortola T, Mirelis B, Navarro G, Cuenca M, Esteve M, Pena C, Llanos AC, Canton R, Pascual A. Community infections caused by extended-spectrum beta-lactamase-producing Escherichia coli. Arch Intern Med. 2008. 168:1897–1902.
11. Hawser SP, Bouchillon SK, Hoban DJ, Badal RE, Canton R, Baquero F. Incidence and antimicrobial susceptibility of Escherichia coli and Klebsiella pneumoniae with extended-spectrum beta-lactamases in community- and hospital-associated intra-abdominal infections in Europe: results of the 2008 Study for Monitoring Antimicrobial Resistance Trends (SMART). Antimicrob Agents Chemother. 2010. 54:3043–3046.
12. Grundmann H, Aires-de-Sousa M, Boyce J, Tiemersma E. Emergence and resurgence of meticillin-resistant Staphylococcus aureus as a public-health threat. Lancet. 2006. 368:874–885.
13. Liu C, Graber CJ, Karr M, Diep BA, Basuino L, Schwartz BS, Enright MC, O'Hanlon SJ, Thomas JC, Perdreau-Remington F, Gordon S, Gunthorpe H, Jacobs R, Jensen P, Leoung G, Rumack JS, Chambers HF. A population-based study of the incidence and molecular epidemiology of methicillin-resistant Staphylococcus aureus disease in San Francisco, 2004-2005. Clin Infect Dis. 2008. 46:1637–1646.
14. Appelbaum PC. The emergence of vancomycin-intermediate and vancomycin-resistant Staphylococcus aureus. Clin Microbiol Infect. 2006. 12:Suppl 1. 16–23.
15. 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. 2008. 46:668–674.
16. Chung G, Cha J, Han S, Jang H, Lee K, Yoo J, Kim H, Eun S, Kim B, Park O, Lee Y. Nationwide surveillance study of vancomycin intermediate Staphylococcus aureus strains in Korean hospitals from 2001 to 2006. J Microbiol Biotechnol. 2010. 20:637–642.
17. Nordmann P, Cuzon G, Naas T. The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria. Lancet Infect Dis. 2009. 9:228–236.
18. Centers for Disease Control and Prevention (CDC). Detection of Enterobacteriaceae isolates carrying metallo-beta-lactamase-United States, 2010. MMWR Morb Mortal Wkly Rep. 2010. 59:750.
19. El Solh AA, Alhajhusain A. Update on the treatment of Pseudomonas aeruginosa pneumonia. J Antimicrob Chemother. 2009. 64:229–238.
20. Li J, Nation RL, Turnidge JD, Milne RW, Coulthard K, Rayner CR, Paterson DL. Colistin: the re-emerging antibiotic for multidrug-resistant Gram-negative bacterial infections. Lancet Infect Dis. 2006. 6:589–601.
21. Michalopoulos AS, Karatza DC. Multidrug-resistant Gram-negative infections: the use of colistin. Expert Rev Anti Infect Ther. 2010. 8:1009–1017.
22. Paul M, Bishara J, Levcovich A, Chowers M, Goldberg E, Singer P, Lev S, Leon P, Raskin M, Yahav D, Leibovici L. Effectiveness and safety of colistin: prospective comparative cohort study. J Antimicrob Chemother. 2010. 65:1019–1027.
23. 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. 2007. 10:59–69.
24. Ko KS, Suh JY, Kwon KT, Jung SI, Park KH, Kang CI, Chung DR, Peck KR, Song JH. High rates of resistance to colistin and polymyxin B in subgroups of Acinetobacter baumannii isolates from Korea. J Antimicrob Chemother. 2007. 60:1163–1167.
25. Song JH. Current status and future strategies of antimicrobial resistance in Korea. Korean J Med. 2009. 77:143–151.