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Norm Norm-Vet 2013 2O13 NORM NORM-VET Usage of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Norway DESIGN, FORSIDE: IDA SKAAR IDA FORSIDE: DESIGN, – SVANEGODKJENT TRYKKSAK – 241 762 241 – TRYKKSAK SVANEGODKJENT – ISSN: 1502-2307 (print) / 1890-9965 (electronic) AS MEDIA LUNDBLAD 2013 NORM NORM-VET Usage of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Norway ISSN: 1502-2307 (print) / 1890-9965 (electronic) Any use of data from NORM/NORM-VET 2013 should include specific reference to this report. Suggested citation: NORM/NORM-VET 2013. Usage of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Norway. Tromsø / Oslo 2014. ISSN:1502-2307 (print) / 1890-9965 (electronic). This report is available at www.vetinst.no and www.antibiotikaresistens.no 1 NORM / NORM-VET 2013 CONTRIBUTORS AND PARTICIPANTS Editors: Gunnar Skov Simonsen NORM, Univ. Hosp. of North Norway Anne Margrete Urdahl NORM-VET, Norwegian Veterinary Institute Authors: Cecilie Torp Andersen Candida spp. [email protected] Oslo Univ. Hosp. Trude Margrete Arnesen Tuberculosis [email protected] Norw. Inst. of Pub. Health Hege Salvesen Blix Antibiotic usage in humans [email protected] Norw. Inst. of Pub. Health Dominique Caugant Meningococci [email protected] Norw. Inst. of Pub. Health Petter Elstrøm MRSA [email protected] Norw. Inst. of Pub. Health Kari Grave Antibiotic usage in animals [email protected] Norw. Vet. Inst. Ina Haagensen Enteropathogenic bacteria from humans [email protected] Norw. Inst. of Pub. Health Kjersti Wik Larssen MRSA [email protected] St. Olav Univ. Hosp. Madelaine Norström Bacteria from animals [email protected] Norw. Vet. Inst. Gunnar Skov Simonsen Bacteria from humans [email protected] NORM, Univ. Hosp. of North Norw. Dagfinn Skaare Haemophilus influenzae [email protected] Vestfold Hospital, Tønsberg Jannice Schau Slettemeås Bacteria from animals [email protected] Norw. Vet. Inst. Martin Steinbakk Group A streptococci [email protected] Norw. Inst. of Pub. Health Marianne Sunde Bacteria from animals [email protected] Norw. Vet. Inst. Gaute Syversen Gonococci [email protected] Oslo Univ. Hosp. Ullevål Anne Margrete Urdahl Bacteria from animals [email protected] NORM-VET, Norw. Vet. Inst. Didrik Vestrheim Pneumococci [email protected] Norw. Inst. of Pub. Health Astrid Louise Wester Enteropathogenic baceria from humans [email protected] Norw. Inst. of Pub. Health Frode Width-Gran MRSA [email protected] St. Olav Univ. Hosp. Institutions participating in NORM-VET: Norwegian Food Safety Authority Kjell Hauge Norwegian Veterinary Institute, Dep. of Health Surveillance Anne Margrete Urdahl / Merete Hofshagen / Madelaine Norström / Kari Grave Norwegian Veterinary Institute, Dep. of Diagnostics Marianne Sunde / Jannice Schau Slettemeås / Aina Steihaug Barstad Institutions participating in NORM: Akershus University Hospital, Lørenskog, Department of Microbiology Trond Egil Ranheim / Marit Vattøy Førde Hospital, Department of Microbiology Reidar Hjetland / Astrid Vedde Haugesund Hospital, Department of Microbiology Liv Jorunn Sønsteby / Pirrko-Liisa Kellokumpu Haukeland Univ. Hospital, Bergen, Dep. of Microbiology Haima Mylvaganam / Torunn Sneide Haukeland Innlandet Hospital, Lillehammer, Department of Microbiology Carola Grub / Kari Ødegaard Levanger Hospital, Department of Microbiology Angela Kümmel / Anne-Kristine Lorås Molde Hospital, Department of Microbiology Einar Vik / Lisa Valle Norwegian Insititute of Public Health, Ref. Lab. for Enteropathogenic Bacteria Astrid Louise Wester / Trine-Lise Stavnes Norwegian Insititute of Public Health, Ref. Lab. for H. influenzae Martin Steinbakk / Gunnhild Rødal Norwegian Insititute of Public Health, Ref. Lab. for M. tuberculosis Turid Mannsåker / Kari Nilsen Norwegian Insititute of Public Health, Ref. Lab. for N. meningitidis Dominique Caugant / Inger Marie Saga Norwegian Insititute of Public Health, Ref. Lab. for S. pneumoniae Didrik Vestrheim / Anne Ramstad Alme Norwegian Insititute of Public Health, Ref. Lab. for S. pyogenes Martin Steinbakk / Anne Ramstad Alme Nordland Hospital, Bodø, Department of Microbiology Liisa Mortensen / Hege Elisabeth Larsen Oslo University Hospital, Radiumhospitalet, Laboratory of Microbiology Peter Gaustad / Sunniva Fagerås Røst Oslo University Hospital, Rikshospitalet, Institute of Medical Microbiology Peter Gaustad / Pia Langseth Oslo University Hospital, Rikshospitalet, Ref. Lab. for Mycology Cecilie Torp Andersen / Aina Myhre Oslo University Hospital, Ullevål, Department of Microbiology Gaute Syversen / Thea Bergheim Oslo University Hospital, Ullevål, Ref. Lab. for N. gonorrhoeae Gaute Syversen / Thea Bergheim Stavanger University Hospital, Department of Microbiology Olav Natås / Anita Løvås Brekken St. Olav University Hospital, Trondheim, Department of Microbiology Jan Egil Afset / Toril Nordtømme St. Olav University Hospital, Trondheim, Ref. Lab. for MRSA Lillian Marstein / Hege Snøsen Sørlandet Hospital, Kristiansand, Department of Microbiology Unn Houge / Ann Kristin Øverland-Glastad Unilabs Telelab A/S, Skien Andreas Emmert / Anne Ragnhild Oseid University Hospital of North Norway, Tromsø, Department of Microbiology Gunnar Skov Simonsen / Ellen Haldis Josefsen University Hospital of North Norway, Nat. Adv. Unit on Detection of AMR Ørjan Samuelsen / Bjørg C. Haldorsen Vestfold Hospital, Tønsberg, Department of Microbiology Dagfinn Skaare / Astrid Lia Vestre Viken - Bærum Hospital, Department of Medical Microbiology Annette Onken / Merriam Sundberg Vestre Viken - Drammen Hospital, Department of Medical Microbiology Krisztina Papp / Hanne Fanuelsen Østfold Hospital, Fredrikstad, Department of Microbiology Anita Kanestrøm / Anne Cathrine Hollekim Ålesund Hospital, Department of Microbiology Reidar Hide / Filip Angeles NORM reference group in 2013: Martin Steinbakk Norwegian Institute of Public Health, Oslo Dag Harald Skutlaberg Haukeland University Hospital, Bergen Anita Kanestrøm Østfold Hospital Trust, Fredrikstad Ståle Tofteland Norwegian Society for Medical Microbiology Thea Bergheim Norwegian Society of Engineers and Technologists Dag Berild Norwegian Society for Infectious Diseases Knut Eirik Eliassen Norwegian College of General Practitioners 2 NORM / NORM-VET 2013 CONTENTS CONTENTS I. Introduction ………………………………………………………………………………………............. 5 II. Sammendrag ..........……………………………………………………………………………….............. 6 III. Summary …………………………………………………………………………………………............ 9 IV. Population statistics.…………………………………………………………………………………........ 12 V. Usage of antimicrobial agents Usage in animals……………………………………………………………………………………...14 Usage in humans.…………………………………………………………………………………..... 18 VI. Occurrence of antimicrobial resistance A. Animal clinical isolates Staphylococcus pseudintermedius from dog ………...………………………………………. 28 B. Indicator bacteria from animals and food Escherichia coli from dogs, layers, turkey and turkey meat …............................................... 31 Extended-spectrum beta-lactamase (ESBL) producing Escherichia coli from dogs, layers, turkey and turkey meat ………………………………………………..……... 34 Enterococcus spp. from layers and turkey …………. ……………………..………………. 36 Vancomycin resistant Enterococcus spp. (VRE) from layers and turkey ………………….. 38 C. Zoonotic and non-zoonotic enteropathogenic bacteria Salmonella spp. ……………………….........................………………...................................... 39 Campylobacter spp. …………………………………. .............................................................. 47 Yersinia enterocolitica .. ……….........................……………………....................................... 51 Shigella spp. .………………….............……….........................…….................................. 52 D. Human clinical isolates Distribution of bacterial species in blood cultures .................................................................... 55 Escherichia coli in blood cultures ………………….............................................................. 57 Escherichia coli in urine ……………………………................................................................ 59 Klebsiella spp. in blood cultures .………………….................................................................... 61 Klebsiella spp. in urine ………………………………………………………………………. 63 Haemophilus influenzae in blood cultures and cerebrospinal fluids …………………………. 69 Neisseria meningitidis in blood cultures and cerebrospinal fluids …………………………… 70 Neisseria gonorrhoeae ……………………………………………………………………….. 71 Staphylococcus aureus in blood cultures …………............................................................... 72 Staphylococcus aureus in wound specimens ............................................................................. 73 Methicillin resistant Staphylococcus aureus (MRSA) infections in Norway 2013 …………… 75 Enterococcus spp. in blood cultures ….……………................................................................ 77 Streptococcus pneumoniae in blood cultures and cerebrospinal fluids ...................................... 82 Streptococcus pyogenes in blood cultures …………….. ………………………………......... 84 Streptococcus pyogenes in specimens from the respiratory tract and wounds .......................... 84 Mycobacterium tuberculosis …….……………......................................................................... 86 Candida spp. in blood cultures ............................................................................................
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