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SWEDRES-SVARM 2003.Indd Swedish Veterinary Antimicrobial Resistance 2003 Monitoring SVARM Preface .............................................................................................4 Summary ..........................................................................................5 Sammanfattning ...............................................................................7 Use of antimicrobials .........................................................................9 Resistance in zoonotic bacteria ......................................................14 Salmonella ..........................................................................................................14 Campylobacter ...................................................................................................17 Resistance in indicator bacteria ......................................................18 Escherichia coli ...................................................................................................18 Enterococcus .....................................................................................................21 Resistance in animal pathogens ......................................................28 Pig ......................................................................................................................28 Cattle ..................................................................................................................30 Horse ..................................................................................................................31 Dog .....................................................................................................................32 Cat ......................................................................................................................35 Appendix 1: Demographic data .......................................................38 Appendix 2: Materials and methods, use of antimicrobials ..............40 Appendix 3: Materials and methods, resistance monitoring ............42 Appendix 4: Antimicrobial agents licensed ......................................46 Appendix 5: References ..................................................................47 © Statens Veterinärmedicinska Anstalt, National Veterinary Institute Uppsala, Sweden Printed by Elanders Berlings, Malmö, Sweden ISSN Produced by the Information Department Graphic production by Björn Lundquist AB, Malmö, Sweden Photographs by Bengt Ekberg, SVA SVARM 2003 Swedish Veterinary Antimicrobial Resistance Monitoring Editors Björn Bengtsson, Christina Greko and Märit Karlsson Department of Antibiotics, National Veterinary Institute, SVA SE-751 89 Uppsala Sweden Authors Department of Antibiotics, National Veterinary Institute,SVA Björn Bengtsson, Anders Franklin, Christina Greko and Märit Karlsson Apoteket AB (National Corporation of Swedish Pharmacies) Kristina Odensvik Fiskhälsan FH AB (Fish Health Control Program) Ulf-Peter Wichhardt SVARM laboratory working group Department of Antibiotics, National Veterinary Institute, SVA Maria Finn, Margareta Horn af Rantzien, Annica Landén and Verena Rehbinder SVARM advisory committee Björn Bengtsson, Anders Franklin, Christina Greko and Märit Karlsson, Department of Antibiotics, SVA Viveka Båverud, Department of Bacteriology, SVA Desirée Jansson, Department of Poultry, SVA Gudrun Orava, Information Department, 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 2003, Swedish Veterinary Antimicrobial Resistance Monitoring. The National Veterinary Institute (SVA), Uppsala, Sweden, 2003. 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 3 3 Preface WELCOME TO THE SECOND Swedish report combining in human and veterinary medicine have been successful in results from the monitoring of antimicrobial resistance and containing resistance. The general concept is to use antimi- antimicrobial usage in both veterinary and human medicine: crobials only when needed, on prescription by a professional SVARM and SWEDRES. It is today generally accepted that only, and that the choice of treatment is based on relevant all use of antimicrobials in different sectors contributes to information. the development of resistance. This joint report will facilitate Notwithstanding, some of the presented results in both comparisons of resistance levels and incidence of use in the veterinary and human fields are cause for concern. Examples two areas. of unfavourable development of resistance indicate that the In Sweden human and veterinary medicine have collabo- antimicrobial arsenal available is becoming more and more rated and communicated over a number of years, not least limited. Further efforts must be made to prevent infectious within the Swedish Strategic Programme for The Rational diseases both in human and in veterinary medicine by other Use of Antimicrobial Agents and Surveillance of Resistance means. (STRAMA). Based on this experience, we are convinced that Our hope is that this report will serve as a basis for policy collaboration and joint efforts between human and veterinary recommendations and intervention strategies, and that it will medicine are essential in order to counteract the threat that anti- increase our understanding of the dynamics of resistance. The microbial resistance poses to both human and animal health. ultimate goal is to preserve the effectiveness of available anti- Data in this report indicate that the Swedish strategies microbials for man and animals. 4 SVARM 2 0 0 3 Summary THE RESULTS PRESENTED in this fourth report from Resistance in zoonotic bacteria SVARM concur with previous reports and other Swedish Antimicrobial resistance in Salmonella from Swedish animals studies, showing that the situation regarding antimicrobial is rare and the situation has been stable since the late 70s, resistance in bacteria of animal origin is stable. Resistance when monitoring of resistance began. The overall prevalence does occur but the proportions are low, viewed from an inter- of resistance in each year’s material is greatly influenced by national perspective. Likewise, data in the corresponding the occurrence of multiresistant isolates of S. Typhimurium, report covering human medicine, SWEDRES (http://www. i.e. resistant to at least three antimicrobials. As these phage- strama.se or http://www.smittskyddsinstitutet.se) generally types (DT104, DT193 and DT120) are rare among food- indicate a favourable situation. producing animals, probably a result of the strategies in the Notwithstanding, some of the presented results in both Swedish Salmonella control programme, the overall preva- human and veterinary fields are cause for concern. Examples lence of resistance is low. Nor is there any indication of spread of unfavourable development of resistance indicate that the of such clones among the notified incidents in wild animals antimicrobial arsenal available is becoming more and more and pets. limited. Further efforts must be made to prevent infectious Year 2003 Campylobacter spp. from pigs were studied. The diseases both in human and in veterinary medicine by other majority of isolates were hippurate-negative thermophilic means. Camplyobacter, most likely C. coli. Generally the antimicro- bial resistance among the isolates tested was low except for Use of antimicrobials a high proportion of resistance to nalidixic acid (18%) and Antimicrobials for use in animals in Sweden are only avail- enrofloxacin (16%). This resistance is difficult to explain in able on veterinary prescription and guidelines emphasising relation to the assumed low use of fluoroquinolones in pigs in judicious use have been issued. Use for growth promotion Sweden. was banned in year 1986. In 2003, a total of 16 metric tons of antimicrobials were used for animals. This represents a Resistance in indicator bacteria decrease by 7% compared with year 2002, and is at least part- In SVARM, antimicrobial resistance in indicator bacteria is ly explained by a true decrease in use of products for in-feed monitored, i.e. in Escherichia coli and Enterococcus spp. from or water medication. Further, a decrease in sales of products the normal enteric microflora of healthy animals. This year, sold with mastitis as one indication is paralleled by a decrease data on indicator bacteria from pigs is reported. in the number of dairy cows. Although usually harmless, these bacteria can form a res- The sales of products formulated for treatment of groups ervoir of resistance genes that can be transferred to bacteria or flocks (in-feed or water medication) have decreased over that cause disease in animals or humans. Moreover, resistance the 90s. This is true also for the use of antimicrobials in among indicator bacteria reflects the selective pressure exert- aquaculture, where the total amounts prescribed (in kg active ed by use of antimicrobials in specific animal populations. substance) have decreased from 259 kg in year 1994 to 40 kg Hence, recommendations on use can be based on trends in in 2003. The reduction of use of antimicrobials for treatment resistance and effects of interventions can be evaluated. If of fishes is correlated with an increased use of vaccines. harmonised methodology is used, resistance in indicator
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