A Decade of Achievements and Future Directions in Global Antimicrobial Resistance Surveillance System in Korea (Kor-GLASS).
OBJECTIVES: To comprehensively evaluate the 10-year operational outcomes (2016-2025) Global Antimicrobial Resistance Surveillance System in Korea (Kor-GLASS), assess its public health significance for national stewardship and global surveillance, and propose strategies for future development. METHODS: The study described the operational framework of Kor-GLASS, including its strain collection, analysis, and quality control systems, based on surveillance data. It analyzed resistance trends among key bloodstream pathogen isolates collected from 2016 to 2024 and evaluated major achievements, including alignment with the World Health Organization (WHO)'s Global Antimicrobial Resistance Surveillance System (GLASS), integration with the Emerging Antimicrobial Resistance Reporting (EAR) system, and activities as a WHO Collaborating Centre. RESULTS: Kor-GLASS operates on a foundation of standardized, isolate-based surveillance supported by an independent quality management system that complies with WHO GLASS standards. In alignment with the strategic direction of WHO GLASS, the surveillance scope has progressively expanded in terms of catchment areas, target pathogens, specimen types, and antimicrobial panels. From 2016 to 2024, a total of 116,955 clinical isolates were collected and analyzed through the network of collection and analysis centers. This has enabled the continuous generation of nationally representative antimicrobial resistance (AMR) data from general hospitals. The accumulated surveillance data provide fundamental evidence for tracking long-term resistance trends and elucidating the molecular epidemiological characteristics of key pathogens. These outcomes are disseminated through the publication of the "National Antimicrobial Resistance Surveillance Annual Report" and data submissions to WHO GLASS and GLASS-EAR, thereby supporting both national and global AMR surveillance efforts. Furthermore, Kor-GLASS has strengthened international surveillance and One Health collaboration capacities through its designation and redesignation as a WHO Collaborating Centre for AMR Surveillance. CONCLUSIONS: Over the past decade, Kor-GLASS has served as the cornerstone of national antimicrobial resistance surveillance, providing evidence to inform policy and supporting global surveillance systems. Moving forward, Kor-GLASS is expected to evolve into a pivotal national AMR surveillance system through the introduction of whole-genome sequencing and stronger integration with national antimicrobial consumption surveillance.