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Swedres-Svarm 2004 SVARM2004 Swedish Veterinary Antimicrobial Resistance Monitoring Preface .............................................................................................4 Summary ..........................................................................................6 Sammanfattning ...............................................................................7 Use of antimicrobials .........................................................................8 Resistance in zoonotic bacteria ......................................................12 Salmonella ..........................................................................................................12 Campylobacter ...................................................................................................15 Resistance in indicator bacteria ......................................................17 Escherichia coli ...................................................................................................17 Enterococcus .....................................................................................................20 Resistance in animal pathogens ......................................................28 Pig ......................................................................................................................28 Cattle ..................................................................................................................29 Horse ..................................................................................................................30 Dog .....................................................................................................................33 Cat ......................................................................................................................37 Appendix 1: Demographic data .......................................................38 Appendix 2: Materials and methods, use of antimicrobials ..............40 Appendix 3: Materials and methods, resistance monitoring ............41 Appendix 4: Antimicrobial agents licensed ......................................45 Appendix 5: References ..................................................................46 © Statens Veterinärmedicinska Anstalt, National Veterinary Institute Uppsala, Sweden Printed by Elanders Berlings, Malmö, Sweden ISSN Produced by SVA Graphic production by Björn Lundquist AB, Malmö, Sweden Photographs by Bengt Ekberg, SVA SVARM 2004 Swedish Veterinary Antimicrobial Resistance Monitoring Editors Björn Bengtsson, Christina Greko and Märit Pringle Department of Antibiotics, National Veterinary Institute (SVA) SE-751 89 Uppsala Sweden Authors Björn Bengtsson, Anders Franklin, Christina Greko and Märit Pringle Department of Antibiotics, SVA Kristina Odensvik Apoteket AB (National Corporation of Swedish Pharmacies) SVARM laboratory working group Maria Finn, Margareta Horn af Rantzien, Annica Landén and Verena Rehbinder Department of Antibiotics, SVA SVARM advisory committee Björn Bengtsson, Anders Franklin, Christina Greko and Märit Pringle, Department of Antibiotics, SVA Viveka Båverud, Department of Bacteriology, SVA Desirée Jansson, Department of Pigs, Poultry and Ruminants, SVA Gudrun Orava, Department of Information, SVA Ivar Vågsholm, Zoonosis Center, SVA Kristina Odensvik, Apoteket AB Text and tables may be cited and reprinted only with reference to this report Suggested citation: SVARM 2004, Swedish Veterinary Antimicrobial Resistance Monitoring. The National Veterinary Institute (SVA), Uppsala, Sweden, 2005. www.sva.se, ISSN 1650-6332. This report is available at www.sva.se Reprints can be ordered from Department of Antibiotics National Veterinary Institute SE-751 89 Uppsala Sweden Phone: +46 (0) 18 67 40 00 Fax: +46 (0) 18 30 91 62 e-mail: [email protected] SVARM 2 0 0 4 3 Preface THIS IS THE THIRD SWEDISH REPORT combining results The overall aim of a national antibiotic strategy is to from the monitoring of antimicrobial resistance and anti- contain antibiotic resistance and thereby preserve the possi- microbial usage in both veterinary and human medicines: bility of effective antibacterial treatment when it is needed. SVARM and SWEDRES. We are convinced that collabora- It is thus evident that resistance rates and trends need to be tion and joint efforts between human and veterinary medi- measured. For the same reason monitoring antibiotic use is cines are essential in order to counteract the threat that anti- important. However, surveillance systems in themselves do microbial resistance poses to both human and animal health. not solve the problem with antibiotic resistance and data According to the Zoonosis Directive that was implemented in must be used for action. Our hope is that this report will the EU in 2003, surveillance of antimicrobial resistance shall provide important knowledge for professional organisations, not only comprise zoonotic organisms such as Salmonella and therapeutic committees and other bodies when policy deci- Campylobacter but should also include indicator bacteria such sions, guidelines, interventions and research strategies are as E. coli and enterococci. The indicator bacteria constitute a made up. reservoir of resistance genes that may be transferred to patho- genic bacteria. 4 SVARM 2 0 0 4 Acknowledgements Tack THE WORK WITH SVARM has involved several people who in ARBETET MED SVARM har involverat många personer various ways have made this report possible. We would like to som på olika sätt gjort det möjligt att sammanställa denna express our gratitude to all those who have contributed and in rapport. Vi vill tacka alla de som bidragit och särskilt följande particular to: personer: Meat inspection personnel from the National Food Köttbesiktningspersonal från Livsmedelsverket, och annan Administration and abattoir staff for collecting samples from personal vid slakterier, för insamling av prov från slaktdjur för slaughtered animals for the study on indicator bacteria. undersökningen av indikatorbakterier. Personnel at the Department of Bacteriology, SVA, and Personal vid Avdelningen för Bakteriologi, SVA, och in particular Viveca Båverud, Erik Eriksson and Ingrid särskilt Viveca Båverud, Erik Eriksson och Ingrid Hansson Hansson, for fruitful discussions on animal pathogens and för diskussioner om djurpatogener och zoonosbakterier. zoonotic bacteria. Kollegor vid SVAs värdefulla diskussioner, råd och Colleagues at SVA for valuable discussions, advice and konstruktiv kritik av manuskript. constructive criticisms of manuscripts. SVARM 2 0 0 4 5 Summary THIS FIFTH REPORT FROM SVARM shows that the situa- could select for resistance also to other substances. tion regarding antimicrobial resistance in bacteria of animal Indicator bacteria are monitored as resistance in the origin is stable. Resistance does occur but viewed from an normal gut flora reflects the antimicrobial selective pressure international perspective the prevalences are low. Likewise, in animal populations. These bacteria can form a reservoir of data in the corresponding report covering human medicine, resistance genes that can be transferred to bacteria that cause SWEDRES (http://www.strama.org or http://www.smitt- disease in animals or humans. If harmonised methodology is skyddsinstitutet.se) indicate a favourable situation. used, resistance in indicator bacteria can be compared on an The total amount of antimicrobials used for animals international level. has declined since the mid 90s but the figures are roughly Vancomycinresistant enterococci (VRE) were only unchanged from year 2000. Over the last five years, the sales obtained from occasional samples from chickens with the of pleuromutilins has decreased by more than 50%, which standard method used in European monitoring programmes. coincides with increased efforts to tackle swine dysentery, the With a more sensitive method, using media supplemented disease for which these drugs are mainly used. It is likely that with vancomycin, VRE were however isolated in a larger the intensive work to control this disease has resulted in a proportion of samples than in previous years. Since the start reduced need of antimicrobials. of monitoring year 2000, the proportion of positive samples The use of fluoroquinolones for animals has increased. from chickens has gradually increased. Although occurrence In particular, the use of tablets for dogs and cats was 80% of VRE is low in an international perspective, the increase higher in year 2004 compared to 1995. The number of dogs is cause for concern since the genes that code for resistance has increased far less since 1998 (13%). No obvious scientific to vancomycin might be transferred to enterococci causing veterinary reasons for this development can be pinpointed. nosocomial infections in humans. The proportion of multiresistant Escherichia coli and Escherichia coli from diagnostic submissions were Staphylococcus intermedius from diagnostic submissions from often resistant to ampicillin, streptomycin, tetracycline dogs is high. The current trend in use of fluoroquinolones for and trimethoprim-sulphonamides, irrespective of source dogs and cats is a concern. It may lead to an increase in resist- (pigs, calves, horses, dogs and cats). For the animal species ance, and ultimately to an increased number of cases where included, the proportion of multiresistance ranged from 7% no antimicrobials are available for treatment. to 29%. Interestingly, among isolates from horses gentamicin Multiresistant Salmonella Typhimurium DT104 was resistance
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