Background: The emergence of tigecycline-resistant Acinetobacter baumannii has been reported, and the need for tigecycline susceptibility testing in this strain is increasing. However, neither the Clinical & Laboratory Standards Institute, nor the European Commission on Antimicrobial Susceptibility Testing have provided definitive criteria for tigecycline susceptibility testing of A. baumannii. In this study, the disk diffusion method and the minimal inhibitory concentration (MIC) method were com pared to verify conventionally used Food and Drug Administration-identified interpretive criteria to detect tigecycline resistance of A. baumannii. Methods: Forty-four strains of A. baumannii with tigecycline resistance were collected through the Kor-GLASS (Korean Global Antimicrobial Resistance Surveillance System) study in 2022 using the disk diffusion test (DDT). This strain was retested with the MIC method using a Sensititre Gram Negative GN6F AST plate (Thermo Fisher Scientific, USA) to confirm tigecycline resistance. The confirmed strain was subjected to whole genome analysis to elucidate the tigecycline resistance mechanism. Results: Only one of the 44 isolates identified as resistant to tigecycline by the DDT showed resistance with the MIC method, thus the concordance rate of the two methods was 2.3% (1/44). Sequence type 195 strain, carrying bla OXA23 was identified. This strain had no resistance genes of the tetracycline family but had resistance genes to other antimicrobial families. Conclusions Discrepancy of the tigecycline susceptibility test of A. baumannii was identified. To detect tigecycline resistance of A. baumannii, more reliable methods are required.

Background and Objectives: This study aimed to analyze the outcomes of Fontan surgery in the Republic of Korea, as there were only a few studies from Asian countries. Methods: The medical records of 1,732 patients who underwent Fontan surgery in 10 cardiac centers were reviewed. Results: Among them, 1,040 (58.8%) were men. The mean age at Fontan surgery was 4.3±4.2 years, and 395 (22.8%) patients presented with heterotaxy syndrome. According to the types of Fontan surgery, 157 patients underwent atriopulmonary (AP) type; 303, lateral tunnel (LT) type; and 1,266, extracardiac conduit (ECC) type. The overall survival rates were 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively. The risk factors of early mortality were male, heterotaxy syndrome, AP-type Fontan surgery, high mean pulmonary artery pressure (mPAP) in pre-Fontan cardiac catheterization, and early Fontan surgery year. The risk factors of late mortality were heterotaxy syndrome, genetic disorder, significant atrioventricular valve regurgitation (AVVR) before Fontan surgery, high mPAP in pre-Fontan cardiac catheterization, and no fenestration. Conclusions In Asian population with a high incidence of heterotaxy syndrome, the heterotaxy syndrome was identified as the poor prognostic factors for Fontan surgery. The preoperative low mPAP and less AVVR are associated with better early and long-term outcomes of Fontan surgery.

Background: The emergence of tigecycline-resistant Acinetobacter baumannii has been reported, and the need for tigecycline susceptibility testing in this strain is increasing. However, neither the Clinical & Laboratory Standards Institute, nor the European Commission on Antimicrobial Susceptibility Testing have provided definitive criteria for tigecycline susceptibility testing of A. baumannii. In this study, the disk diffusion method and the minimal inhibitory concentration (MIC) method were com pared to verify conventionally used Food and Drug Administration-identified interpretive criteria to detect tigecycline resistance of A. baumannii. Methods: Forty-four strains of A. baumannii with tigecycline resistance were collected through the Kor-GLASS (Korean Global Antimicrobial Resistance Surveillance System) study in 2022 using the disk diffusion test (DDT). This strain was retested with the MIC method using a Sensititre Gram Negative GN6F AST plate (Thermo Fisher Scientific, USA) to confirm tigecycline resistance. The confirmed strain was subjected to whole genome analysis to elucidate the tigecycline resistance mechanism. Results: Only one of the 44 isolates identified as resistant to tigecycline by the DDT showed resistance with the MIC method, thus the concordance rate of the two methods was 2.3% (1/44). Sequence type 195 strain, carrying bla OXA23 was identified. This strain had no resistance genes of the tetracycline family but had resistance genes to other antimicrobial families. Conclusions Discrepancy of the tigecycline susceptibility test of A. baumannii was identified. To detect tigecycline resistance of A. baumannii, more reliable methods are required.

Background: The emergence of tigecycline-resistant Acinetobacter baumannii has been reported, and the need for tigecycline susceptibility testing in this strain is increasing. However, neither the Clinical & Laboratory Standards Institute, nor the European Commission on Antimicrobial Susceptibility Testing have provided definitive criteria for tigecycline susceptibility testing of A. baumannii. In this study, the disk diffusion method and the minimal inhibitory concentration (MIC) method were com pared to verify conventionally used Food and Drug Administration-identified interpretive criteria to detect tigecycline resistance of A. baumannii. Methods: Forty-four strains of A. baumannii with tigecycline resistance were collected through the Kor-GLASS (Korean Global Antimicrobial Resistance Surveillance System) study in 2022 using the disk diffusion test (DDT). This strain was retested with the MIC method using a Sensititre Gram Negative GN6F AST plate (Thermo Fisher Scientific, USA) to confirm tigecycline resistance. The confirmed strain was subjected to whole genome analysis to elucidate the tigecycline resistance mechanism. Results: Only one of the 44 isolates identified as resistant to tigecycline by the DDT showed resistance with the MIC method, thus the concordance rate of the two methods was 2.3% (1/44). Sequence type 195 strain, carrying bla OXA23 was identified. This strain had no resistance genes of the tetracycline family but had resistance genes to other antimicrobial families. Conclusions Discrepancy of the tigecycline susceptibility test of A. baumannii was identified. To detect tigecycline resistance of A. baumannii, more reliable methods are required.

Background and Objectives: This study aimed to analyze the outcomes of Fontan surgery in the Republic of Korea, as there were only a few studies from Asian countries. Methods: The medical records of 1,732 patients who underwent Fontan surgery in 10 cardiac centers were reviewed. Results: Among them, 1,040 (58.8%) were men. The mean age at Fontan surgery was 4.3±4.2 years, and 395 (22.8%) patients presented with heterotaxy syndrome. According to the types of Fontan surgery, 157 patients underwent atriopulmonary (AP) type; 303, lateral tunnel (LT) type; and 1,266, extracardiac conduit (ECC) type. The overall survival rates were 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively. The risk factors of early mortality were male, heterotaxy syndrome, AP-type Fontan surgery, high mean pulmonary artery pressure (mPAP) in pre-Fontan cardiac catheterization, and early Fontan surgery year. The risk factors of late mortality were heterotaxy syndrome, genetic disorder, significant atrioventricular valve regurgitation (AVVR) before Fontan surgery, high mPAP in pre-Fontan cardiac catheterization, and no fenestration. Conclusions In Asian population with a high incidence of heterotaxy syndrome, the heterotaxy syndrome was identified as the poor prognostic factors for Fontan surgery. The preoperative low mPAP and less AVVR are associated with better early and long-term outcomes of Fontan surgery.

Background and Objectives: This study aimed to analyze the outcomes of Fontan surgery in the Republic of Korea, as there were only a few studies from Asian countries. Methods: The medical records of 1,732 patients who underwent Fontan surgery in 10 cardiac centers were reviewed. Results: Among them, 1,040 (58.8%) were men. The mean age at Fontan surgery was 4.3±4.2 years, and 395 (22.8%) patients presented with heterotaxy syndrome. According to the types of Fontan surgery, 157 patients underwent atriopulmonary (AP) type; 303, lateral tunnel (LT) type; and 1,266, extracardiac conduit (ECC) type. The overall survival rates were 91.7%, 87.1%, and 74.4% at 10, 20, and 30 years, respectively. The risk factors of early mortality were male, heterotaxy syndrome, AP-type Fontan surgery, high mean pulmonary artery pressure (mPAP) in pre-Fontan cardiac catheterization, and early Fontan surgery year. The risk factors of late mortality were heterotaxy syndrome, genetic disorder, significant atrioventricular valve regurgitation (AVVR) before Fontan surgery, high mPAP in pre-Fontan cardiac catheterization, and no fenestration. Conclusions In Asian population with a high incidence of heterotaxy syndrome, the heterotaxy syndrome was identified as the poor prognostic factors for Fontan surgery. The preoperative low mPAP and less AVVR are associated with better early and long-term outcomes of Fontan surgery.