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Surveillance plays a pivotal role in overcoming antimicrobial resistance (AMR) in bacterial pathogens, and a variety of surveillance systems have been set up and employed in many countries. In 2015, the World Health Organization launched the Global Antimicrobial Resistance Surveillance System (GLASS) as a part of the global action plan to enhance national and global surveillance and research. The aims of GLASS are to foster development of national surveillance systems and to enable collection, analysis and sharing of standardised, comparable and validated data on AMR between different countries. The South Korean AMR surveillance system, Kor-GLASS, is compatible with the GLASS platform and was established in 2016 and based on the principles of representativeness, specialisation, harmonisation and localisation. In this report, we summarise principles and processes in order to share our experiences with other countries planning to establish a national AMR surveillance system. The pilot operation of Kor-GLASS allowed us to understand the national burden of specific infectious diseases and the status of bacterial AMR. Issues pertaining to high costs and labour-intensive operation were raised during the pilot, and improvements are being made.


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  1. World Health Organization (WHO). Antimicrobial resistance: Global report on surveillance. Geneva: WHO; 2014. [Accessed Feb 2018]. Available from: http://www.who.int/drugresistance/documents/surveillancereport/en/
  2. The Review on antimicrobial resistance. Antimicrobial resistance: Tackling a crisis for the health and wealth of nations. London: HM Government; Dec 2014. Available from: https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf
  3. Word Health Organization (WHO). Global action plan on antimicrobial resistance. Geneva: WHO; 2015. Available from: http://www.wpro.who.int/entity/drug_resistance/resources/global_action_plan_eng.pdf
  4. European Centre for Disease Prevention and Control (ECDC). Surveillance of antimicrobial resistance in Europe 2016. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net). Stockholm: ECDC; 2017. Available from: http://ecdc.europa.eu/en/publications-data/antimicrobial-resistance-surveillance-europe-2016
  5. Word Health Organization (WHO). Global antimicrobial resistance surveillance system: Manual for early implementation. Geneva: WHO; 2015. Available from: http://www.who.int/entity/antimicrobial-resistance/publications/surveillance-system-manual/en/index.html
  6. World Health Organization Western Pacific Region (WHO-WPR). Antimicrobial resistance in the Western Pacific Region: a review of surveillance and health systems response. Manila: WHO-WPR: 2015. Available from: http://apps.who.int/medicinedocs/documents/s22116en/s22116en.pdf
  7. Hong SJ, Yong D, Lee K, Kim E-C, Lee WK, Jeong SH, et al. Antimicrobial resistance of clinically important bacteria isolated from hospitals located in representative provinces of Korea. Korean J Clin Microbiol.2003;6(1):29-36.
  8. Kim D, Ahn JY, Lee CH, Jang SJ, Lee H, Yong D, et al. Increasing resistance to extended-spectrum cephalosporins, fluoroquinolone, and carbapenem in Gram-negative bacilli and the emergence of carbapenem non-susceptibility in Klebsiella pneumoniae: analysis of Korean Antimicrobial Resistance Monitoring System (KARMS) data from 2013 to 2015. Ann Lab Med. 2017;37(3):231-9.  https://doi.org/10.3343/alm.2017.37.3.231  PMID: 28224769 
  9. Ryu S. The new Korean action plan for containment of antimicrobial resistance. J Glob Antimicrob Resist. 2017;8:70-3.  https://doi.org/10.1016/j.jgar.2016.10.013  PMID: 28024981 
  10. Korean Statistical Information Service (KOSIS). Principal indicators of Asia-Pacific Economic Cooperation (APE) countries. Daejeon: Statistics Korea. [Accessed 29 Sep 2018]. Korean. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_2KAAG02&conn_path=I2
  11. Shin BM, Chae SL, Min WK, Lee WG, Lim YA, Lee DH, et al. The implementation and effects of a clinical laboratory accreditation program in Korea from 1999 to 2006. Korean J Lab Med. 2009;29(2):163-70.  https://doi.org/10.3343/kjlm.2009.29.2.163  PMID: 19411785 
  12. Leber AL. Clinical microbiology procedures handbook 4th ed. Washington D.C.: ASM Press; 2016.
  13. Alexander M. Laboratory Manual on Preservation, Freezing, and Freeze-Drying as Applied to Algae, Bacteria, Fungi and Protozoa. Rockville: American Type Culture Collection; 1980.
  14. La Scola B, Gundi VA, Khamis A, Raoult D. Sequencing of the rpoB gene and flanking spacers for molecular identification of Acinetobacter species. J Clin Microbiol. 2006;44(3):827-32.  https://doi.org/10.1128/JCM.44.3.827-832.2006  PMID: 16517861 
  15. Clinical and Laboratory Standards Institute (CLSI). Interpretive criteria for identification of bacteria and fungi by DNA target sequencing; approved guideline MM18-A. Wayne: CLSI; 2008.
  16. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing M100-S26. Wayne; CLSI: 2016.
  17. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Recommendations for MIC determination of colistin (polymyxin E) As recommended by the joint CLSI-EUCAST Polymyxin Breakpoints Working Group. Växjö: EUCAST; 22 Mar 2016. Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/General_documents/Recommendations_for_MIC_determination_of_colistin_March_2016.pdf
  18. Kondo Y, Ito T, Ma XX, Watanabe S, Kreiswirth BN, Etienne J, et al. Combination of multiplex PCRs for staphylococcal cassette chromosome mec type assignment: rapid identification system for mec, ccr, and major differences in junkyard regions. Antimicrob Agents Chemother. 2007;51(1):264-74.  https://doi.org/10.1128/AAC.00165-06  PMID: 17043114 
  19. Kahl BC, Mellmann A, Deiwick S, Peters G, Harmsen D. Variation of the polymorphic region X of the protein A gene during persistent airway infection of cystic fibrosis patients reflects two independent mechanisms of genetic change in Staphylococcus aureus. J Clin Microbiol. 2005;43(1):502-5.  https://doi.org/10.1128/JCM.43.1.502-505.2005  PMID: 15635028 
  20. Shin HB, Jeong SH, Kim M, Kim WH, Lee K, Chong Y. Isolation trend of enteropathogenic bacteria in 1969-1998. Korean J Clin Microbiol.2001;4(2):87-95.
  21. Lee H, Hong SG, Soe Y, Yong D, Jeong SH, Lee K, et al. Trends in antimicrobial resistance of Neisseria gonorrhoeae isolated from Korean patients from 2000 to 2006. Sex Transm Dis. 2011;38(11):1082-6.  https://doi.org/10.1097/OLQ.0b013e31822e60a4  PMID: 21992988 
  22. Jeongbu24. “Gamgie hangsaengje cheobang geuman” hangsaengje naeseong-gwanli daepog ganghwa! [“No more antimicrobial prescription for the common cold” Strengthening the governance related to antimicrobial resistance]. 11 Aug 2016. Korean. Available from: https://www.gov.kr/portal/gvrnPolicy/view/156146703
  23. Ministry of the Interior and Safety. Gugga hangsaengje naeseong gwanlidaechaeg [National Action Plan on Antimicrobial Resistance (2016–2020). Seoul: Ministry of the Interior and Safety; 11 Aug 2016. Korean. Available from: https://www.gov.kr/portal/gvrnPolicy/view/156146703

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