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ANSORP was organized as the first multicountry collaborative study group in Asia for the surveillance of antimicrobial resistance. Organization of the ANSORP was first initiated by Prof. Jae-Hoon Song (Samsung Medical Center, Sungkyunkwan Univ., Seoul, Korea) in 1996 to perform the international surveillance studies on antimicrobial resistance in the Asian region. The initial project by the ANSORP group was the surveillance of pneumococcal resistance. 
Since 1996, ANSORP has been expanding in structures and organizations.

ANSORP was reorganized in 1998 for the second-year project which is the nasopharyngeal carriage of drug-resistant pneumococci in Asian children. Among original members, several principal investigators did not join the second-year project. As of 2006, 52 principal investigators from 22 centers in 13 countries are participating in the ANSORP Study Group. ANSORP is one of the world-largest collaborative study groups for the antimicrobial research.
The first-year research project by the ANSORP Study Group was the surveillance of antimicrobial resistance among Streptococcus
pneumoniae in Asian countries. This was the first organized surveillance study of the prevalence of drug-resistant S. pneumoniae in the Asian region.
For the study, a total of 996 isolates of S. pneumoniae isolates which were consecutively collected from clinical specimens in 14 centers in
11 Asian countries during the period from September 1996 to June 1997 were tested.

Data revealed that preumococcal resistance is a serious problem in some Asian cities.

Data from molecular epidemiologic studies indicated that it may be partly due to the spread of resistant clones within and between Asian countries as well as due to injudicious use of antimicrobial agents.
Continuous surveillance of pneumococcal resistance is strongly warranted in this region in the future. Data from the first-year project by the ANSORP Study Group will appear in the June 1999 issue of the Clinical Infectious Diseases.

The second-year research project by the ANSORP Study Group during the period between 1998 and early 1999 is the nasopharyngeal carriage of drug-resistant pneumococci in Asian children. As pneumococcal disease follows nasopharyngeal carriage, previous studies showed that the antimicrobial susceptibility profile of nasopharyngeal strains reflects that of invasive strains.

Thus, it appears that the use of nasopharyngeal isolates from children on admission to hospital, or attending an outpatient clinic, can be used as an estimate of the incidence of resistance in systemic isolates. Carriage rates in different countries could reveal the background reason for different status of pneumococcal resistance in Asia.
ANSORP is a growing network for researches on antimicrobial resistance and infectious diseases in the Asian region. As it was developed independently, ANSORP is owned by principal investigators in Asian countries. The initial future visions of the ANSORP can be summarized as followings ;

First, ANSORP will continue to perform the international multicenter researches on antimicrobial resistance as well as clinical trials in the Asian region. Future research plans or ideas will be raised by ANSORP investigators. The 3rd-year project by the ANSORP study group was "The clinical impact of antimicrobial resistance among invasive pneumococcal pathogens in Asian countries". The study was performed in 25 centers in 13 countries in Asia and Middle East.

Second, ANSORP will remain "independent" study group for the international collaboration study in the Asian region. It is not owned by a certain pharmaceutical company or other societies. ANSORP may have the relationship with the Western Pacific Society for Chemotherapy (WPSC) or International Society for Chemotherapy (ISC) for more effective activities in the future.


(1) Epidemiology and clinical characteristics of community-acquired pneumonia in Asian countries (2001-2003)
After completion of serial surveillance of pneumococcal resistance, ANSORP project from 2001 was the current project for surveillance of CAP in Asian countries. Given the lack of relevant data on CAP in the region with regard to etiologic distribution, clinical characteristics, antibiotic uses and clinical outcome, this study could generate very important information.

(2) Molecular characterization of macrolide-resistant or fluoroquinolone-resistant S. pneumoniae from Asian countries (2002)
This basic study was performed to characterize the prevalence of macrolide resistance genes
(erm and mef) and fluoroquinolone resistance genes (gyrA, gyrB, parC, and parE) among
Asian pneumococcal strains.

(3) Surveillance of antimicrobial resistance among enteric pathogens from Asian Countries* (2002-2003)
This project initiated by Prof. Cheng-Hsun Chiu in Taiwan was to investigate the antimicrobial resistance among Salmonella and Shigella strains from Asian countries. Strains of Salmonella, Shigella, and cholera have been collected from ANSORP countries.

(4) Epidemiology and clinical impact of community-acquired methicillin-resistant Staphylococcus aureus in Asian countries (2005-present)
Emergence of CA-MRSA is obviously an important issue not only from the epidemiologic point of view but also from the clinical standpoint. However, epidemiology of CA-MRSA in the Asian region has not been fully described. This prospective multinational surveillance study will be the first study to investigate the epidemiologic, clinical, microbiological, and molecular characteristics of CA-MRSA strains in the Asian region.








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