A1258150525bifOD

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A N S O R P Asian Network for Surveillance of
Resistant Pathogens
Envisioning the future against infectious
diseases
Jae-Hoon Song Visanu Thamlikitkul On behalf
of ANSORP Samsung Medical Center, Sungkyunkwan
University, Seoul, Korea Mahidol University,
Bangkok, Thailand
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Globalization of Resistance
Reason for international collaboration
?
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Surveillance of Antimicrobial Resistance
Basic aims
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Surveillance of Antimicrobial Resistance
Multiple steps and functions
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International Surveillance Systems
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Population and Antibiotic Use in the World
(United Nations Population Division, 2000 IMS
data, 1999)
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Asian-Pacific Research Foundation for Infectious
Diseases
ARFID
ANSORP
Asian Network for Surveillance of Resistant
Pathogens
IDRI
ABB
Asian Bacterial Bank
Infectious Disease Research Institute
ISAAR
International Symposium on Antimicrobial Agents
and Resistance
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ARFID and ANSORP
Mission
ARFID and ANSORP are founded to contribute to the
improvement of the public health in the
Asian-Pacific region through international
collaboration for research on infectious diseases
and antimicrobial resistance
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ARFID and ANSORP
Vision 2010
ARFID and ANSORP will be a central system of
biomedical research on infectious diseases and
antimicrobial agents and resistance through
international collaboration that enables
effective control and prevention of infectious
diseases and antimicrobial resistance in the
Asia-Pacific region
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ARFID and ANSORP
Historical evolution The first phase
(1996-2002)
1996
2003
2002
2001
2000
1999
1998
1997
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Asian Network for Surveillance of Resistant
Pathogens
ANSORP Structural Evolution
1996
2003
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26 Investigators 14 Centers 11
Countries/areas
55 Investigators 31 Centers 12
Countries/areas
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Asian Network for Surveillance of Resistant
Pathogens
ANSORP structural evolution
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Asian Network for Surveillance of Resistant
Pathogens
ANSORP Founding members
Jae-Hoon Song (Seoul) Nam Yong Lee (Seoul)
Wang Fu (Shanghai)
Anan Chongthaleong (Bangkok) Nalinee Aswapokee
(Bangkok)
Satoshi Ichiyama (Nagoya) Ryoji Yoshida (Nagasaki)
Cheng-Hsun Chiu (Taipei)
M.K. Lalitha (Vellore)
Bui Xuan Vinh (HCM city)
Farida Jamal (Kuala Lumpur)
Ti Teow Yee (Singapore)
Jennifer Perera (Colombo)
Usman C. Warsa (Jakarta)
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Asian Network for Surveillance of Resistant
Pathogens
Far East Section
Samsung Medical Center
Beijing Childrens Hosp.
Dong-A Univ. Kyungbook Univ. ChoongNam
Univ. Chungbuk Univ. ChonNam Univ. Kangbuk
Hosp. Hallym Univ. Veterans Hosp.
Beijing Chaoyang Hosp.
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Chang Gung Childrens Hosp. National Univ. of
Taiwan
Shanghai Childrens Hosp.
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Rui Jin Hosp. (Shanghai)
Princess Margaret Hosp. (Hong Kong)
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Asian Network for Surveillance of Resistant
Pathogens
Southeast Asia Section
Univ. of Medicine Pharmacy (HCM city)
Nguyen Tri Phuong Hosp (HCM city)
Chulalongkorn Univ. (Bangkok)
Mahidol Univ. (Bangkok)
RITM (Manila)
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SGH
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Univ. Putra Malaysia (Kuala Lumpur)
NUS (Singapore)
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Univ. Malaya (Kuala Lumpur)
Univ. of Indonesia (Jakarta)
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Asian Network for Surveillance of Resistant
Pathogens
Southwest Asia / Middle East Section
Christian Medical College (Vellore)
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Univ. of Colombo (Colombo)
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Asian Network for Surveillance of Resistant
Pathogens
ANSORP Program evolution
Surveillance In vitro studies
1996
2000
1999
1998
1997
2003
2002
2001
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Asian Network for Surveillance of Resistant
Pathogens
ANSORP Program evolution
Molecular analysis of MDR pneumococci
Molecular analysis of FQ-R pneumococci
Molecular analysis of Macrolide-R pneumococci
Clinical trial Basic research
Phase IIIb gemifloxacin clinical trial for PRSP
pneumonia
1996
2000
1999
1998
1997
2003
2002
2001
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Asian Network for Surveillance of Resistant
Pathogens
ANSORP Program evolution
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ANSORP Data Pneumococcal Resistance
Penicillin resistance in Asia
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685 invasive isolates from 12 Asian countries
of PRSP
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Vietnam
India
China
Korea
Thailand
Sri Lanka
Malaysia
Taiwan
Hong Kong
Singapore
Philippines
Saudi Arabia
(penicillin MIC ? 2 mg/L)
(Song JH ANSORP. Antimicrob Agents Chemother,
in press)
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ANSORP Data Pneumococcal Resistance
Macrolide resistance in Asia
92
86
685 invasive isolates from 12 Asian countries
81
77
74
of erythromycin resistance
China
Taiwan
India
Korea
Malaysia
Singapore
Vietnam
Thailand
Sri Lanka
Philippines
Hong Kong
Saudi Arabia
(erythromycin MIC ? 1 mg/L)
(Song JH ANSORP. Antimicrob Agents Chemother,
in press)
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High-level Macrolide Resistance in Asia
Country MIC90 of strains by
mechanisms (ug/mL) erm
mef ermmef Korea (n67) gt 128 40.4
21.1 38.6 China (n86) gt 128 76.9
3.1 20 Taiwan (n47) gt 128 70.7 29.3
0 Hong Kong (n102) gt 128 24.4 66.7
8.9 Vietnam (n60) gt 128 45.3
5.7 49.1 Thailand (n32) 4 28.6
71.4 0 Singapore (n17) 128 44.4
55.6 0
Invasive pneumococcal pathogens (2000-2001)
(Song JH et al. J Antimicrob Chemother. 53457,
2004)
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ANSORP Data Pneumococcal Resistance
Multi-drug Resistance in Asia

685 invasive isolates from 12 Asian countries
of MDR strains
71
45
45
41
23
Vietnam
Taiwan
Hong Kong
Korea
China
MDR ? 3 drugs among invasive strains
(Song JH ANSORP. Antimicrob Agents Chemother,
in press)
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ANSORP Data Pneumococcal Resistance
Spread of resistance in Asia
Sp 23F
Asian strains
(Song JH et al. Clin Infect Dis 28 1206-11,
1999)
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ANSORP Data Pneumococcal Resistance
Carriage of DRSP in Asian Children
Penicillin resistance
Macrolide resistance
(Lee NY Song JH et al. Clin Infect Dis. May,
2001)
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ANSORP Data Pneumococcal Resistance
Country with high prevalence of resistance
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Asian Network for Surveillance of Resistant
Pathogens
In its first 7 years, ANSORP has ..
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Future ANSORP System
Expanded structure More comprehensive
surveillance Rapid reliable information
source Interactive communication Strong
partnership
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Future ANSORP System
A gateway to Asia

• In 2010, ANSORP will have ..
• more than 50 centers
• in 20 - 25 cities
• in gt 15 countries / areas
• in Asia and the Middle East
• To perform international collaboration
• against infectious disease threats

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New candidate centers
Current centers
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Future ANSORP System
Partnership with other organizations
ALEXANDER
SENTRY
WARN
EARSS
APUA
TSN
WHO
CDC
ANSORP
PAHO
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Future ANSORP Projects
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ARFID and ANSORP