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Usage of Antimicrobial Agents and Occurance Og Antimicobial Resistance in Norway

Usage of Antimicrobial Agents and Occurance Og Antimicobial Resistance in Norway

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1
2006
NORM
NORM-VET

Usage of Antimicrobial
Agents and Occurrence of
Antimicrobial Resistance
in Norway

ISSN: 1502-2307
Any use of data from NORM/NORM-VET 2006 should include specific reference to this report.
Suggested citation: NORM/NORM-VET 2006. Usage of Antimicrobial Agents and Occurrence of Antimicrobial
Resistance in Norway. Troms\u00f8 / Oslo 2007. ISSN:1502-2307.
This report is available atwww . v et inst . noa nd w ww .a nt ibio t ika re sist en s. no
NORM / NORM-VET 2006
2
CONTRIBUTORS AND PARTICIPANTS
Editors:
Madelaine Norstr\u00f6m
NORM-VET, Nat. Vet. Inst.
Gunnar Skov Simonsen NORM, Univ. Hosp. of North Norway / Norw. Inst. of Pub. Health
Authors:
Hege Salvesen Blix
Usage in humans
hegesbl@ulrik.uio.no
Norw. Inst. of Pub. Health
Arne Broch Brants\u00e6ter
Human clinical isolates
arne.brantsaeter@sabhf.no
B\u00e6rum Hosp.
Petter Gaustad
Human clinical isolates
peter.gaustad@rikshospitalet.no Rikshospitalet, Univ. of Oslo
Kari Grave
Usage in animals,
kari.grave@veths.no

Norw. School of Vet. Sc./ Nat. Vet. Inst.
animal indicator bacteria and
enteropathogenic bacteria

kari.grave@veths.no
Norw. School of Vet. Sc./ Nat. Vet. Inst.
J\u00f8rgen Lassen
Enteropathogenic bacteria
jorgen.lassen@fhi.no
Norw. Inst. of Pub. Health
Turid Manns\u00e5ker
Human clinical isolates
turid.mannsaker@fhi.no
Norw. Inst. of Pub. Health
Madelaine Norstr\u00f6m
Animal indicator bacteria and
enteropathogenic bacteria
madelaine.norstrom@vetinst.no NORM-VET, Nat. Vet. Inst.
Per Sandven
Human clinical isolates
per.sandven@fhi.no
Norw. Inst. of Pub. Health
Gunnar Skov Simonsen Human clinical isolates
gunnar.skov.simonsen@unn.no NORM, Univ. Hosp. of North Norway
Trine-Lise Stavnes
Enteropathogenic bacteria
trine-lise.stavnes@fhi.no
Norw. Inst. of Pub. Health
Martin Steinbakk
Human clinical isolates
drmartin@online.no
NORM, Akershus Univ. Hosp.
Marianne Sunde
Animal indicator bacteria
marianne.sunde@vetinst.no
Nat. Vet. Inst.
Institutions participating in NORM-VET:
Norwegian Food Safety Authority
National Veterinary Institute, Norwegian Zoonosis Centre
Madelaine Norstr\u00f6m / Merete Hofshagen
National Veterinary Institute, Section of Bacteriology
Marianne Sunde / Hanne Tharaldsen
Norwegian Institute of Public Health
J\u00f8rgen Lassen / Trine-Lise Stavnes
Institutions participating in NORM:
Aker University Hospital, Department of Bacteriology
Ragnhild Raastad / Bitten Rasmussen
Akershus University Hospital, Department of Microbiology
Martin Steinbakk / Siri Haug H\u00e4nsgen and Marit Einvik
B\u00e6rum Hospital, Central Laboratory, Section of Microbiology
Bj\u00f8rn Odd Johnsen / Merriam Sundberg
Central Hospital of Buskerud, Department of Microbiology
Helvi Samdal / Ellen Grimstad
Central Hospital of Nordland, Department of Microbiology

Liisa Mortensen / Jeanett Larsen
Central Hospital of Nord-Tr\u00f8ndelag, Levanger, Department of Microbiology Arne Mehl / Anne-Kristine Lor\u00e5s
Central Hospital of Oppland, Lillehammer, Department of Microbiology

Viggo Hasseltvedt / Kari \u00d8degaard
Central Hospital of \u00d8stfold, Department of Microbiology
Eivind Ragnhildstveit / Anne Cathrine Hollekim
Stavanger University Hospital, Department of Microbiology
Elisebet Haarr / Anita L\u00f8v\u00e5s Brekken
Central Hospital of Sogn og Fjordane, Department of Microbiology
Reidar Hjetland / Astrid Vedde
Central Hospital of Vest-Agder, Department of Microbiology
St\u00e5le Tofteland / Torill S. Larsen
Central Hospital of Vestfold, Department of Microbiology
Dagfinn Skaare / Astrid Lia
Central Hospital of Hordaland, Haugesund, Department of Microbiology

Liv Jorunn S\u00f8nsteby / Pirrko-Liisa Kellokumpu
County Hospital of M\u00f8re og Romsdal, Molde, Department of Microbiology Einar Vik / Heidi Tomren
County Hospital of M\u00f8re og Romsdal, \u00c5lesund, Department of Microbiology Reidar Hide / May Bente Mar\u00f8
Haukeland Univ. Hospital, Department of Immunology and Microbiology

Dag Harald Skutlaberg / Torunn Sneide Haukeland
Rikshospitalet, University of Oslo, Institute of Medical Microbiology
Fredrik M\u00fcller / Magli B\u00f8vre
National Cancer Hospital, Laboratory of Microbiology
Truls Leegaard / Merete R. Ueland
National Reference Laboratory for Enteropathogenic Bacteria
J\u00f8rgen Lassen / Trine-Lise Stavnes
Telelab A/S, Skien
Yngvar Tveten / Monika Kollstr\u00f8m
Ullev\u00e5l University Hospital, Department of Microbiology
Gaute Syversen / Thea Bergheim
University Hospital of North Norway, Department of Microbiology
Gunnar Skov Simonsen / Siv-Heidi Barkhald
St. Olav University Hospital, Trondheim, Department of Microbiology
Trond Jacobsen / Marianne Dorothea Wiig
Capio laboratoriemedisin, Department of Microbiology, Oslo
Wibeke Aasn\u00e6s / Nina Clausen
NORM reference group in 2006:
Inger Sofie Samdal Vik
Norwegian Institute of Public Health
Fredrik M\u00fcller
Rikshospitalet, University of Oslo, Institute of Medical Microbiology
Astrid Lia
Central Hospital of Vestfold, Department of Microbiology
Olav Nat\u00e5s
Central Hospital of Rogaland, Department of Microbiology
Arne Broch Brants\u00e6ter
Norwegian Institute of Public Health
Elisabeth von der Lippe
Ullev\u00e5l University Hospital, Department of Infectious Diseases
Mark Fagan
Froland Community Health Center
The NORM and NORM-VET programmes are part of the
Norwegian Government\u2019s Action Plan against Antimicrobial Resistance issued in 2000.
NORM / NORM-VET 2006
CONTENTS3
CONTENTS

I. Introduction\u2026\u2026 \u2026\u2026 \u2026\u2026\u2026 \u2026\u2026\u2026\u2026 \u2026\u2026\u2026 \u2026\u2026\u2026 \u2026\u2026 \u2026\u2026\u2026\u2026 \u2026\u2026\u2026 \u2026\u2026\u2026 \u2026\u2026 \u2026\u2026............. 5 II. Sammendrag (norsk)\u2026\u2026\u2026 \u2026\u2026\u2026\u2026 \u2026\u2026\u2026 \u2026\u2026\u2026 \u2026\u2026 \u2026\u2026\u2026\u2026 \u2026\u2026\u2026 \u2026\u2026\u2026 \u2026\u2026 \u2026\u2026\u2026.......... 6 III. Summary (English)\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026......... 9 IV. Population statistics.\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026....... 13 V. Usage of antimicrobial agents

Usage in animals\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026..... 15
Usage in humans.\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026.... 19
VI. Occurrence of antimicrobial resistance
Indicator bacteria from animals and food
Escherichia coli from broiler.. . . . . . . . .. . . .\u2026\u2026\u2026\u2026\u2026\u2026............................................ 27
Enterococcus spp. from broiler. . . . . .. . . . . .. . . .\u2026\u2026\u2026\u2026\u2026........................................... 31
Zoonotic and non-zoonotic enteropathogenic bacteria

Salmonellasp p.\u2026\u2026\u2026\u2026\u2026 \u2026\u2026\u2026\u2026......................... \u2026\u2026\u2026\u2026\u2026\u2026.................. 3 5 Campylobactersp p .\u2026\u2026\u2026\u2026\u2026\u2026\u2026 \u2026\u2026\u2026 \u2026\u2026\u2026.. . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . 4 2 Yersinia enterocolitica ..\u2026\u2026\u2026.........................\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026.................... 46 Shigella spp. . .\u2026\u2026\u2026\u2026\u2026\u2026\u2026.............\u2026\u2026\u2026.........................\u2026\u2026.................... 47

Human clinical isolates
Distribution of bacterial species in blood cultures.................................................. 49

Escherichia coli in blood cultures\u2026\u2026 \u2026\u2026\u2026 \u2026\u2026.............................................. 51 Escherichia coli in urine\u2026\u2026 \u2026\u2026\u2026\u2026 \u2026\u2026\u2026 \u2026\u2026............................................. 53 Klebsiella spp. in blood cultures\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026.............................................. 54 Proteus mirabilis in urine. . . . . . . . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . .. . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . 57 Staphylococcus aureus in blood cultures\u2026 \u2026\u2026 \u2026................................................ 60 Staphylococcus aureus in wound specimens........................................................... 62 Enterococcus spp. in blood cultures \u2026.\u2026\u2026\u2026\u2026\u2026.............................................. 65 Streptococcus pneumoniae in blood cultures \u2026\u2026\u2026................................................ 67 Streptococcus pyogenes in blood cultures, respiratory tract specimens

and wound specimens \u2026\u2026\u2026......................................\u2026\u2026......................... 70

Streptococcus agalactiae from systemic infections................................................ 73 Mycobacterium tuberculosis\u2026\u2026.\u2026\u2026\u2026\u2026\u2026...................................................... 7 4 Candida spp. in blood cultures. . . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . . .. . . . .. . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . . 75

HIV resistance among persons diagnosed with HIV-infection in Norway.............. 77

Use of antibacterials in ambulatory care, by Hege Salvesen Blix. . . . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . . . . .. 25 New national centre for antibiotic use and resistance in primary care, by Morten Lindb\u00e6k. ......... 26 First description of an extended spectrum beta-lactamase (ESBL)-producing Escherichia coli

from Norwegian Livestock, by Marianne Sunde, Hanne Tharaldsen and Madelaine Norstr\u00f6m..... 30
The EUCAST process of breakpoint setting in antimicrobial susceptibility testing,

by Martin Steinbakk. . . . . . . . . . . . . . .. . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . .. . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . .. . . . . . . 58 MRSA infections in Norway, by Peter Elstr\u00f8m. . . . . . . . . . . . . . .. . . . . .. . . . . . .\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026.. 64 HIV resistance \u2013 clinical implications and current laboratory methods for clinical use,

by Vidar Ormaasen. . . . . . . . . . .. . . . .. . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . .. . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . .. . . . . . . . 78

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