SVARM|2008 Swedish Veterinary Antimicrobial Resistance Monitoring 2 SVARM|2008 Content Swedish Veterinary Antimicrobial Resistance Monitoring 2008 Preface .................................................................................. 3 Summary ............................................................................... 4 Editors Björn Bengtsson, Stina Englund, Christina Sammanfattning.................................................................... 6 Greko and Ulrika Grönlund Andersson Use of antimicrobials ........................................................... 8 Department of Animal Health and Antimicrobial Strategies, National Veterinary Zoonotic bacteria ................................................................ 14 Institute (SVA) Salmonella ........................................................................ 14 SE-751 89 Uppsala, Sweden Campylobacter .................................................................. 18 Authors Indicator bacteria ................................................................ 22 Björn Bengtsson, Karin Bergström, Stina Escherichia coli .................................................................. 22 Englund, Christina Greko, Ulrika Grönlund Enterococcus ...................................................................... 27 Andersson, Oskar Nilsson and Ulrika Windahl Department of Animal Health and Antimicrobial Animal pathogens ............................................................... 35 Strategies, SVA Pig ................................................................................... 35 Cattle .............................................................................. 39 SVARM laboratory working group Kerstin Ekström, Maria Finn, Margareta Farmed fish ..................................................................... 40 Horn af Rantzien, Eva Hübbinette, Annica Horse .............................................................................. 40 Landén and Eva Säker Dog ................................................................................. 43 Department of Animal Health and Antimicrobial Cat .................................................................................. 44 Strategies, SVA Appendix 1: Demographic data .......................................... 46 Text and tables may be cited and reprinted Appendix 2: Materials and methods, use of antimicrobials 48 only with reference to this report Suggested citation: SVARM 2008, Swedish Appendix 3: Materials and methods, resistance monitoring 49 Veterinary Antimicrobial Resistance Appendix 4: Antimicrobial agents licensed ......................... 54 Monitoring. The National Veterinary Institute (SVA), Uppsala, Sweden, 2009. www. Appendix 5: References ....................................................... 55 sva.se, ISSN 1650–6332. Appendix 6: SVARM 2000-2008 – an overview .................. 57 This report is available at www.sva.se Reprints can be ordered from Department of Animal Health and Antimicrobial Strategies 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] © Statens Veterinärmedicinska Anstalt, National Veterinary Institute, Uppsala, Sweden Printed by Edita Västra Aros, Västerås, Sweden ISSN Produced by SVA Graphic production by Björn Lundquist AB, Malmö, Sweden Photographs by Bengt Ekberg, SVA, SVARM|2008 3 Preface WELCOME to the ninth Swedish report combining results from An outbreak of methicillin-resistant S. aureus (MRSA) among the monitoring of antimicrobial resistance and antimicrobial horses admitted to an equine hospital attracted considerable usage in both veterinary and human medicine: SVARM and attention, not least from media. This was also true for the first SWEDRES. These joint reports facilitate comparisons of cases of MRSA in dogs reported in 2006 and 2007. On a posi- resistance levels and incidence of use in the two areas. tive note, the attention has led to a generally increased aware- ness of the problems with antimicrobial resistance. In small Data in this and previous reports indicate that the Swedish animal medicine, matters related to antimicrobial policy and strategies in human and veterinary medicine have been hospital hygiene have been intensively discussed both nation- comparatively successful in containing resistance. But anti- ally and locally. The pronounced decrease in sales of antimi- microbial resistance continues to increase in many parts of crobials for dogs over the last two years highlighted in this the world. Resistance emerging in one country can rapidly report is probably the result of these combined efforts. spread to others through trade and travel, which underlines the need for international collaboration in all fields. The need In Sweden, the strategic programme against antimicrobial for continued collective efforts in all sectors was iterated in resistance is co-ordinated by Strama. A secretariat to support the European Union’s Council Conclusions on Antimicrobial a network with a similar remit, Strama VL, was initiated at Resistance (10 June 2008). SVA during 2008. Strama VL will provide a platform for all stakeholders to exchange of information, analyze problems, In veterinary medicine, the emergence and spread of multire- pinpoint solutions and initiate prioritized activities. Our hope sistant methicillin-resistant Staphylococcus pseudintermedius is that the information in SWEDRES and SVARM, is trans- (MRSP) among dogs in Sweden and elsewhere continues to be lated into further investigations and action in order to preserve a serious problem, as the options left for treatment are scant. our increasingly threatened, but still favourable, situation. 4 SVARM|2008 Summary THE 2008 REPOrt from SVARM shows that the situation Campylobacter jejuni from broilers were susceptible to all regarding antimicrobial resistance in bacteria of animal origin antimicrobials tested but in hippurate negative isolates from remains favourable from an international perspective. But the slaughter pigs, presumptive Campylobacter coli, fluoroqui- emergence of methicillin resistant Staphylococcus pseudinterme- nolone resistance was common (29%). This agrees with previ- dius (MRSP) in dogs illustrates that the situation can rapidly ous data from SVARM and is possibly linked to use of fluoro- change in an unfavourable direction. However combined quinolones in piglet producing herds. In slaughter pigs, treat- efforts to counter this development have resulted in an overall ment with injectable fluoroquinolones is probably uncom- decrease in use of antimicrobials for dogs. Prudent use of anti- mon and oral administration through feed or water is not microbials reduces the selection pressure for resistance and is a uthorized. one of the cornerstones to mitigate antimicrobial resistance. Resistance in indicator bacteria, i.e. Escherichia coli and The total amount of antimicrobials used for animals was Enterococcus spp. from the intestinal flora of healthy animals, 16 365 kg in 2008, which is similar to year 2005 and among are believed to reflect the antimicrobial selective pressure in the lower figures this decade. The amount of antimicrobials an animal population. In indicator bacteria from sheep, resist- for in-feed or in-water medication has decreased by 93% since ance was rare in agreement with a limited use of antimicrobials 1984 and is today but 15 % of the total sales. The sales of prod- in this animal species. In pigs, resistance to antimicrobials used ucts for medication of individual animals have remained rela- in pig production was not uncommon but occurrence is low tively unchanged over the last decade. The sales of fluoroqui- in an international perspective and without obvious trends. nolones has decreased by 16% over the last three years which is Screening of samples from pigs show that Escherichia coli with explained by decreased use both of injectable products (mainly transferable resistance to third generation cephalosporins is for food producing animals) and of products for oral medica- at most rare. tion of individual animals (mainly for dogs). This year data on indicator bacteria from food is introduced The sales of antimicrobials for dogs have decreased by in SVARM. Fifty samples of pork from retail were cultured in 11% since 2006, measured as total number of prescrip- a pilot study. Resistance was most uncommon but the small tions dispensed. Downward trends are noted for the major number of samples preclude valid conclusion. In future a groups; cephalosporins (-32%), fluoroquinolones (-21%) and larger number of samples will be cultured. aminopenicillins with clavulanic acid (-9%). The findings of methicillin resistant staphylococci in 2006 attracted consider- Vancomycin resistant enterococci (VRE) were isolated able attention, not least in the media. This in turn triggered from 28% of 107 samples of caecal content from broilers national and local initiatives on hygiene and prescribing poli- cultured on media supplemented with vancomycin. This is a cies, which probably led to the observed changes in prescrib- similar prevalence as in 2006 and 2007, which shows that the ers’ behaviour. increase in prevalence of VRE in broilers observed 2000-05 has levelled off. Methicillin resistant Staphylococcus aureus (MRSA) were confirmed in three dogs and seven horses in 2008. Since first Escherichia coli from clinical submissions were often resist- reported in 2006, there have been ten cases in dogs, one in a cat ant to ampicillin, streptomycin, tetracycline or