Antimicrobial resistance of major clinical pathogens in South Korea, May 2016 to April 2017: first one-year report from Kor-GLASS

Antimicrobial resistance (AMR) is a growing burden in both clinical and socioeconomic context owing to the high morbidity and prolonged hospitalisation of patients that causes elevated medical and societal costs because of loss of productivity. The World Health Organization launched the Global AMR Surveillance System (GLASS) in 2015 as a core global action plan addressing this issue. The standardised GLASS manual allowed an overview of global AMR rates through international comparison.

An AMR surveillance system in South Korea, the Korean AMR Monitoring System (KARMS), had been operated between 2002 and 2015 by Korean Centers for Disease Control and Prevention (KCDC). KARMS played an important role in notifying the high AMR rates in South Korea, urging the government to develop a national action plan. However, this system had limitations. Firstly, the antimicrobial susceptibility testing (AST) methods were not well harmonised across the participating clinical laboratories, affecting reliability. Secondly, duplicated isolates were not sufficiently filtered out, which could lead to an overestimation of the national AMR rates. Finally, the epidemiological interpretation of the study was limited because of insufficient clinical data.

From KARMS, the KCDC established an improved AMR surveillance system compatible with the GLASS, named Kor-GLASS [5]. The Kor-GLASS manual was customised from that of GLASS: (i) three bacterial species from blood specimens were added, namely Enterococcus faecalis and Enterococcus faecium to monitor vancomycin resistance and Pseudomonas aeruginosa to monitor carbapenem resistance and (ii) more target antimicrobial agents for AST were included to investigate multi-drug resistance by species.

We have operated the Kor-GLASS for one year since May 2016 and report here the first one-year assessment until April 2017.