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DANMAP 2015 3D
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danmap 2015 74
resistance
in zoonotic bacteria 6. as in most of europe, resistance to macrolides (erythromycin), aminoglycosides (gentamicin and streptomycin) and chloram- phenicol have remained at a very low level. 6.2.2 c. jejuni
from imported broiler meat as in previous years, the levels of resistance quinolones (79%) and tetracycline (56%) in imported poultry meat (n=62) were higher than the levels of observed in isolates
from domesti- cally produced broilers (table 6.3). most of the imported broiler meat tested originated from eu member states, and the trends in resistance among the danmap isolates reflect the general increase in resistance to tetracycline and quinolones (figure 6.4). interestingly, the decline in tetracycline resistance observed among the isolates from danish broilers is also observed among the isolates from imported broiler meat (from 80% in 2013 to 56% in 2015). 6.2.3 c. jejuni in cattle a total of 138 campylobacter spp. isolates were derived from 183 cattle ceaca from all of denmark, and a total of 101 c. jejuni isolates were susceptibility tested. most of the isolates (68%) were fully sensitive to the six antimicrobials included in the test panel, and the remaining isolates were resistant to quinolones (25%) and/or tetracycline (12%). one isolates were resistant to streptomycin only (table 6.3). over the last 15 years the proportion of fully sensitive isolates has varied between 66% and 95%. from 2004 to 2005 resis- tance to quinolones increased from 2% to 32%, however only 27 isolates were tested in 2005 (figure 6.5). despite contin- ued low consumption of fluoroquinolones in cattle, resistance to fluoroquinolones (ciprofloxacin) among c. jejuni from cattle, resistance levels varied between 16% and 22% from 2006 to 2014. initially, quinolone-resistant c. jejuni isolates came from cattle farms in southern jutland, but has now spread to other parts of denmark. most years, resistance to tetracycline has been below 5%. in c. jejuni from cattle, however, tetracycline resistance increased from 2014 to 2015, reaching the highest level of tetracycline resistance reported in c. jejuni from danish cattle since 2002 (figure 6.5). this is not a reflection of an increase in the use of tetracyklines in cattle, which remained at the same level as in 2014. 6.2.4 c. jejuni in humans in 2015, campylobacter continued as the most frequent cause of bacterial intestinal infections in denmark. a total of 4,348 human laboratory confirmed cases of campylobacteriosis were reported (77 per 100,000 inhabitants) [annual report on zoo- noses in denmark 2015]. a random selection of the campylobacter isolated from stool samples in three of five geographical regions were submitted to ssi for species identification and susceptibility testing. in 2015, 188 c. jejuni isolates were susceptibility tested. information on travel history was collected through phone in- terviews, and among the tested isolates, 23% were from travel- associated cases and 77% were domestically acquired. among the domestically acquired infections, 54% were fully sensitive to all the antimicrobial agents tested, while the percentage of fully sensitive isolates was much lower among isolates from travel associated cases (9%). the occurrence of resistance to ciprofloxacin and tetracycline continued to be significantly higher in travel associated c. jejuni isolates (79% and 72%, respectively) compared to isolates from domestically acquired infections (42% and 23%, respectively) (table 6.3). among the resistant isolates, most were resistant to ciproflox- acin and nalidixic acid often in combination with tetracycline cattle broilers broiler meat humans antimicrobial agent danish % danish % danish % import % domestically acquired % travel abroad % total % tetracycline 12 11 10 56 23 72 34 erythromycin 0 0 3 5 4 2 4 streptomycin 1 2 5 8 4 7 5 gentamicin 0 0 0 0 1 5 2 ciprofloxacin 25 27 23 79 42 79 51 nalidixic acid 25 23 23 76 42 79 51 number of isolates 101 44 39 62 145 43 188 table 6.3. resistance (%) in campylobacter jejuni isolates from animals, meat of danish and imported origin and human cases(a), denmark a) an isolate is categorised as ?domestic sporadic? if the patient did not travel outside denmark one week prior to the onset of disease danmap 2015
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