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DANMAP 2015 3D
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109 danmap
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8. resistance
in human clinical bacteria gentamycin and cefuroxime (figure 8.6) show a similar trend with an increase in resistance continuing until around 2011 and thereafter reaching a stabilization, but without a following decreasing trend in resistance as observed for ciprofloxacin resistance in e. coli . for cefuroxim one dcm, (skejby), reported relatively high resistances in 1995 to 1998 with a peak of 9% resistance in 1997. whether this had a methodologically explanation or any other explanations is yet to be elucidated. sissel skovgaard, ute wolff sönksen and stefan s. olsen 8.2 klebsiella pneumoniae klebsiella pneumoniae is part of the normal intestinal flora in humans but can also be the cause of urinary tract-, respiratory tract-, and bloodstream infections. many of these infections are hospital acquired and can become life threatening, espe- cially if the strains are resistant to antimicrobial agents. for k. pneumoniae , danmap 2015 includes data on resistance referred from all 11 departments of clinical microbiology (dcm). blood isolates
from hospital patients statens serum institut has since 2006 received data on the antimicrobial susceptibility of k. pneumoniae isolates from blood, and following a sudden increase in resistance (owing to an outbreak with the so called epi-k.pn .in 2007) data were included in the danmap report from 2008 and onwards. in 2015, danmap received data on 943 k. pneumonia isolates. 0 5 10 15 20 2008 2009 2010 2011 2012 2013 2014 2015 % resistant isolates piperacillin/tazobactam (n=935) ciprofloxacin (n=934) gentamicin (n=937) cefuroxime (n=930) 3rd gen. cephalosporin (n=926) meropenem (n=853) 0 5 10 15 20 25 30 35 40 2009 2010 2011 2012 2013 2014 2015 % resistant isolates sulfonamide (n=5141) ciprofloxacin (n=7106) gentamicin (n=6248) cefuroxime (n=6356) 3rd gen. cephalosporin (n=6512) 0 5 10 15 20 25 30 35 40 2009 2010 2011 2012 2013 2014 2015 % resistant isolates sulfonamide (n=4829) ciprofloxacin (n=5272) 3rd gen. cephalosporin (n=6015) figure 8.7. resistance (%) in klebsiella pneumoniae blood isolates from humans, denmark note: the number (n) in parentheses represents the number of isolates tested for susceptibility in 2015. danmap 2015 0 2 4 6 8 10 12 14 16 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 dcm 1, 2, 3 og 4 cefuroxime cefuroxime gentamicin ciprofloxacin dcm 1, 2, 3 og 4 gentamicin 3rd gen. cephalosporin piperacillin/tazobactam meropenem % resistant isolates % resistant isolates 0 10 20 30 40 50 60 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 dcm 1, 2, 3 og 4 ampicillin ampicillin cefuroxime gentamicin dcm 1, 2, 3 og 4 cefuroxime ciprofloxacin 3rd gen. cephalosporin piperacillin/tazobactam dcm 1, 2, 3 og 4 gentamicin meropenem figure 8.6 resistance (%) in escherichia coli blood isolates from humans, denmark, 20 years of surveillance, excl. ampicillin danmap 2015
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