Results from the Survey of Antibiotic Resistance (SOAR) 2012–14 in Thailand, India, South Korea and Singapore
Journal of Antimicrobial Chemotherapy May 2016 V.71 Suppl 1 i3-i19
Torumkuney, R. Chaiwarith, W. Reechaipichitkul, K. Malatham, V. Chareonphaibul, C. Rodrigues, D. S. Chitins, M. Dias, S. Anandan, S. Kanakapura, Y. J. Park, K. Lee, H. Lee, J. Y. Kim, Y. Lee, H. K. Lee, J. H. Kim, T. Y. Tan, Y. X. Heng, P. Mukherjee, and I. Morrissey
1GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
2Faculty of Medicine, Chiang Mai University, Maharaj Nakorn Chiang Mai Hospital, 110 Intavaroros Road, Tambon Sribhoom, Muang, Chiang Mai 50200, Thailand
3Khon Kaen University Faculty of Medicine, Srinagarind Hospital, 123 Mittraphap Highway, Tambol Naimuang, Muang District, Khon Kaen 40002, Thailand
4Mahidol University Faculty of Medicine Ramathibodi Hospital, 270 Rama VI. Road, oong Phayathai, Ratchathewi, Bangkok 10400, Thailand
5GlaxoSmithKline Thailand, 12th Floor, Wave Place, 55 Wireless Road, Lumpini, Patumwan, Bangkok 10330, Thailand
6Hinduja Hospital and Medical Research Centre, Department of Microbiology, Veer Savarkar Marg, Mahim, Mumbai 400 016, India
7Choithram Hospital and Research Centre, Department of Microbiology, Manik Bagh Road, Indore 452 014 (M/P), India
8St John’s Medical College Hospital, Department of Microbiology, Sarjapur Road, Bangalore 560 034, India
9Christian Medical College, Department of Microbiology, Vellore 632 004, India
10GlaxoSmithKline India, No. 5 Embassy Links, Cunningham (SRT) Road, Bangalore 560 052, India
11The Catholic University of Korea, Seoul St Mary’s Hospital, 222 Banpo-daero, Seocho-Gu, Seoul, South Korea
12Yonsei University College of Medicine, Severance Hospital, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea
13Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, South Korea
14Hanyang University Medical Center, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, South Korea
15The Catholic University of Korea, Uijongbu St Mary’s Hospital, 271, Cheonbo-ro, Ukjeongbu-si, Gyeonggi-do, Korea
16GlaxoSmithKline Korea, LS Yongsan Tower, 9th Floor, Hangang 191, Yongsan-gu, Seoul, South Korea
17Changi General Hospital Pte Ltd (Reg. No. 198904226R), 2 Simei Street 3, Singapore 529889
18GlaxoSmithKline Singapore, (Reg. No. 198102938K), 150 Beach Road, No. 22-00 Gateway West, Singapore 189720
19IHMA Europe Sàrl, 9A Route de la Corniche, Epalinges 1066, Switzerland
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.
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.
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%).
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.