Improvement Plan for the Korean Nationwide Surveillance of Antimicrobial Resistance Program

which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial In recent years, the sudden increase in the prevalence of an-timicrobial-resistant bacteria and the emergence of multi-drug-resistant bacteria have become serious worldwide problems. Therefore, in 2000, the World Health Organization (WHO) declared antimicrobial resistance to be an international danger, and has been working with its member nations to promote the appropriate use of antimicrobials as a solution to the antimicrobial resistance threat [1]. The recent emergence of New Delhi metallo-β-lactamase carbapenem-resistant Enterobacteriaceae has motivated us to increase our alertness to antimicrobial-resistant organisms [2]. Thus, surveillance of healthcare-associated infection has been enhanced. Surveillance for antimicrobial resistance is being executed mainly in European countries and in the U.S. In Korea, with the enactment of the Infectious Disease Control and Prevention Act in December 2010, infectious diseases caused by 6 types of multidrug-resistant bacteria—vancomycin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, methicillin-resistant S. aureus, multidrug-resistant Pseudo-monas aeruginosa, multidrug-resistant Acinetobacter bau-mannii, and carbapenem-resistant Enterobacteriaceae—were legally designated for sentinel surveillance [3]. The prevalence of antimicrobial resistance in bacteria varies substantially from country to country and according to the date of the analysis and the hospital characteristics, because it is influenced significantly by the use of antimicrobial drugs and the degree of success of efforts to control the spread of resistant bacteria. The purposes of an antimicrobial resistance surveillance system (ARSS) are as follows: (1) to detect anti-microbial susceptibility patterns; (2) to monitor the identity, transmission, and expression of antimicrobial-resistance genes; (3) to provide important information on the development of bacterial resistance mechanisms in different regions; and (4) to allow changes in antimicrobial prescription practices and participation of infection control professionals. Well-designed antimicrobial resistance surveillance systems are needed when fighting bacterial resistance. The parameters of an ideal ARSS are as follows: global geography, year-on-year longevity, multiple species selection, centralized methods and test sites, large sample size, monitoring for many anti-microbial drugs, incorporation of epidemiology, and frequent data distribution [4]. Implementation of an ARSS requires 4 components: administrative commitments, system organization (participant, expert, and coordinator), financial support