Jae Han Sohn

Pasteurella multocida is an important zoonotic pathogen that causes soft-tissue infections in humans; however, recent antimicrobial susceptibility data in Korea remain limited. A total of 70 clinical P. multocida isolates collected at a nationwide commercial laboratory in Korea between November 2022 and July 2025 were analyzed. Antimicrobial susceptibility testing was performed using the disk diffusion method on Mueller-Hinton agar supplemented with 5% sheep blood. Five clinically relevant antimicrobial agents were tested: penicillin, amoxicillin-clavulanic acid (AMC), levofloxacin, tetracycline, and trimethoprim-sulfamethoxazole (TMP-SMX). For isolates classified as penicillin non-susceptible by disk diffusion, minimum inhibitory concentration (MIC) testing was performed using E-test and β-lactamase production was assessed using a phenotypic method. All tested isolates were susceptible to tetracycline and TMP-SMX by disk diffusion. Susceptibility rates by disk diffusion were 97.1% for AMC, 91.4% for levofloxacin, and 85.7% for penicillin. All 10 isolates initially classified as penicillin non-susceptible by disk diffusion were confirmed to be susceptible to penicillin by MIC testing and were β-lactamase negative. The 2 isolates classified as non-susceptible to AMC by disk diffusion were also β-lactamase negative and susceptible to penicillin by MIC testing. No β-lactam resistance was identified among the 70 clinical P. multocida isolates analyzed. These findings support current recommendations that β-lactams and other first-line agents remain active against P. multocida isolates in Korea.

Background: Rifampin plays an important role in tuberculosis treatment. In recent years, the introduction of molecular testing techniques has enabled the rapid detection of rifampin resistance, leading to discrepancies with conventional methods. The World Health Organization (WHO) has analyzed mutations in the rpoB gene that induce rifampin resistance and identified certain mutations causing borderline resistance, which are often undetected using conventional tests. Consequently, the WHO has lowered the rifampin resistance criterion concentration from 1.0 to 0.5 μg/mL in 7H10 and MGIT 960. The present study aimed to evaluate the impact of this change in critical concentration on the detection of borderline rifampin resistance in Mycobacterium tuberculosis. Methods: Tuberculosis strains submitted for antituberculosis drug susceptibility testing from May 2021–2022 were analyzed. Three institutions participated; the Seoul Clinical Laboratories used the agar proportion method, whereas the Samsung Medical Center and Seoul National University Bundang Hospital utilized the MGIT 960 system to test both the original and revised concentrations. Mutations were confirmed through rpoB gene sequencing for strains showing discrepancies. Results: A total of 1,596 valid susceptibility tests were conducted during the study period. Rifampin resistance was detected in 35 cases (2.19%) at 1.0 μg/mL and in 38 cases (2.38%) at 0.5 μg/mL, whereas isoniazid resistance was observed in 158 cases (9.90%). Among the three rifampin discrepancy strains, one harbored an H445L mutation, whereas the remaining two exhibited an L452P mutation. These mutations were classified as borderline resistant. Conclusion: Applying the new rifampin critical concentration resulted in a 0.19% increase in resistance rate and an 8.57% increase in detection cases. Additionally, despite testing with large number of rifampin-susceptible strains, no false resistance results were obtained. Therefore, the application of the new critical concentration is considered beneficial for the management of rifampin-resistant tuberculosis.