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- van de Sande-Bruinsma, Nienke, et al.
(författare)
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Antimicrobial drug use and resistance in Europe
- 2008
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Ingår i: Emerging Infectious Diseases. - : Centers for Disease Control and Prevention (CDC). - 1080-6040 .- 1080-6059. ; 14:11, s. 1722-30
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Tidskriftsartikel (refereegranskat)abstract
- Our study confronts the use of antimicrobial agents in ambulatory care with the resistance trends of 2 major pathogens, Streptococcus pneumoniae and Escherichia coli, in 21 European countries in 2000-2005 and explores whether the notion that antimicrobial drug use determines resistance can be supported by surveillance data at national aggregation levels. The data obtained from the European Surveillance of Antimicrobial Consumption and the European Antimicrobial Resistance Surveillance System suggest that variation of consumption coincides with the occurrence of resistance at the country level. Linear regression analysis showed that the association between antimicrobial drug use and resistance was specific and robust for 2 of 3 compound pathogen combinations, stable over time, but not sensitive enough to explain all of the observed variations. Ecologic studies based on routine surveillance data indicate a relation between use and resistance and support interventions designed to reduce antimicrobial drug consumption at a national level in Europe.
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| 7. |
- Börjesson, Stefan, 1979-, et al.
(författare)
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Characterization of plasmid-mediated AmpC-producing E. coli from Swedish broilers and association with human clinical isolates
- 2013
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Ingår i: Clinical Microbiology and Infection. - : European Society of Clinical Microbiology and Infectious Diseases (ESCMID). - 1198-743X .- 1469-0691. ; 19:7, s. E309-E311
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Tidskriftsartikel (refereegranskat)abstract
- A selection of plasmid-mediated AmpC-producing Escherichia coli isolates carrying blaCMY-2 from Swedish broilers were characterized to establish their relatedness to and a possible overlap with human clinical E. coli isolates. The results showed diversity among the E. coli isolated from broilers, indicating that the spread in the population was not due to one strain. However, only one type of plasmid belonging to replicon type incK was identified. Furthermore, there were no indications of spread of blaCMY-2 E. coli isolates from broilers to human clinical settings, although Swedish broilers may be a source of blaCMY-2 and/or the plasmid carrying blaCMY-2 .
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- Hedberg, Anna, et al.
(författare)
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Penetration of fusidic acid and rifampicin into cerebrospinal fluid in low-grade inflammatory meningitis caused by Staphylococcus epidermidis
- 2004
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Ingår i: Clinical Microbiology and Infection. - : Elsevier BV. - 1198-743X .- 1469-0691. ; 10:8, s. 765-768
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Cerebrospinal fluid (CSF) concentration-time curves of rifampicin and fusidic acid were studied in a patient with post-operative meningitis caused by Staphylococcus epidermidis. The patient was treated with this combination of antimicrobial agents because of a severe hypersensitivity reaction to vancomycin. Peak CSF concentrations of rifampicin exceeded the MIC by > 60-fold, while those of fusidic acid just reached the MIC. CSF concentrations of fusidic acid were relatively stable within the range reported for patients with uninflamed meninges, but serum levels were surprisingly low. An increase in the metabolism of fusidic acid induced by rifampicin cannot be excluded.
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- Hogberg, L, et al.
(författare)
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Penicillin-resistant pneumococci in Sweden 1997-2003: Increased multiresistance despite stable prevalence and decreased antibiotic use
- 2006
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Ingår i: Microbial Drug Resistance. - : Mary Ann Liebert Inc. - 1076-6294 .- 1931-8448. ; 12:1, s. 16-22
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Tidskriftsartikel (refereegranskat)abstract
- Antimicrobial resistance patterns and capsular groups of penicillin-resistant Streptococcus pneumoniae (PRP; MIC penicillin G >= 0.5 mg/ml) in Sweden between 1997 and 2003 were described, and trends in resistance and antibiotic sales during the same period were compared. The most common serogroups were in descending order 9, 19, 14, 23, and 6. Despite a low and stable annual PRP rate (proportion of PRP out of all pneumococci) of around 2% during the study period, the proportion of PRP resistant to other antibiotics increased. Of all tested PRP isolates, 82% were also resistant to trimethoprim/sulfamethoxazole, 32% had additional resistance to tetracycline, and 26% to erythromycin. Antibiotic sales figures for all studied antibiotic subgroups decreased during the same period. Little correlation was found between antibiotic sales and PRP resistance rates, indicating that there are still other poorly defined factors contributing to the reported resistance levels in the population. However, although PRP strains in Sweden are becoming more commonly resistant to antibiotics other than beta-lactams, the low and further reduced antibiotic sales still might have delayed the development and rapid spread of PRP in the population.
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- Olsson-Liljequist, B, et al.
(författare)
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Antimicrobial susceptibility testing in Sweden. III. Methodology for susceptibility testing
- 1997
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Ingår i: Scandinavian Journal of Infectious Diseases. Supplementum. - 0300-8878. ; 105, s. 13-23
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Tidskriftsartikel (refereegranskat)abstract
- A subcommittee of the Swedish Reference Group for Antibiotics, SRGA-M, has worked with standardization of methodology for susceptibility testing. In vitro data obtained with the disk diffusion procedure were collected from 5 clinical laboratories, compiled and presented as histograms of inhibition zones, and compared with data [minimum inhibitory concentrations (MICs) and inhibition zones] obtained from the reference laboratory at the Swedish Institute for Infectious Disease Control on a collection of clinically relevant bacterial species. Results from the reference collection of strains were presented as MIC histograms, and their corresponding inhibition zones were inserted in the compiled zone histograms as identifiable bars. These distributions formed the basis for decisions of breakpoints. Special tests were recommended for the detection of certain resistance mechanisms. A beta-lactamase test should be used for Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae and enterococci. Screening for beta-lactam resistance caused by altered penicillin binding proteins should be done by using oxacillin 1 microgram for Streptococcus pneumoniae and Staphylococcus aureus (MRSA), and by phenoxymethylpenicillin 10 micrograms for H, influenzae. The standardized disk diffusion procedure was helpful in detecting enterobacteria carrying beta-lactamases with extended spectra. Registration of inhibition zones will provide a powerful tool for the epidemiological surveillance of antibiotic resistance.
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- Petersson, A C, et al.
(författare)
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Evaluating the usefulness of spa typing, in comparison with pulsed-field gel electrophoresis, for epidemiological typing of methicillin-resistant Staphylococcus aureus in a low-prevalence region in Sweden 2000-2004.
- 2010
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Ingår i: Clinical Microbiology and Infection. - : Elsevier BV. - 1469-0691 .- 1198-743X. ; 16, s. 456-462
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Tidskriftsartikel (refereegranskat)abstract
- Clin Microbiol InfectAbstract The usefulness of spa typing was evaluated in relation to pulsed-field gel electrophoresis (PFGE), as a tool for epidemiological typing of methicillin-resistant Staphylococcus aureus (MRSA) in a low-prevalence region in southern Sweden. Bacterial isolates from 216 MRSA cases, newly identified in 2000-2004, were studied. The isolates were obtained from infected patients (31%), and from colonized individuals found by screening (69%). In total, 49 spa types and 73 PFGE patterns were identified. The discriminatory power of spa typing was lower (94.9 +/- 1.8%) than that of PFGE (97.3 +/- 1.2%). For two spa types (t002 and t008) the Panton-Valentine leukocidin results added useful discriminatory information. The most common spa types were t044 (n = 31; four PFGE patterns), t002 (n = 24; 10 PFGE patterns), t067 (n = 12; four PFGE patterns), t050 (n = 12; one PFGE pattern), and t324 (n = 11; one PFGE pattern). Epidemiological investigations identified 91 single cases and 39 transmission chains, each involving two to 13 cases. All the transmission chains were held together both by spa and PFGE typing. Among the 91 single-case isolates, 33 spa types and 50 PFGE patterns were unique (matchless) at the time of identification. The low prevalence of MRSA, the low number of outbreaks, and the wide spectrum of strains due to frequent acquisitions abroad (49% of the cases), makes spa typing a useful complement to epidemiological investigations in our setting. However, we still recommend the continued use of PFGE for further discrimination of isolates with identical spa types when epidemiological data can not exclude possible transmission.
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| 31. |
- Pickering, Chris, et al.
(författare)
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Identification of neurotransmitter receptor genes involved in alcohol self-administration in the rat prefrontal cortex, hippocampus and amygdala
- 2007
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Ingår i: Progress in Neuro-psychopharmacology and Biological Psychiatry. - : Elsevier BV. - 0278-5846 .- 1878-4216. ; 31:1, s. 53-64
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Forskningsöversikt (refereegranskat)abstract
- About half of the risk to develop alcoholism is related to genetic background and it is well known that alcohol consumption is highly individualized. In this study, we investigated how individual alcohol consumption behaviour in Wistar rats correlated with mRNA expression of 20 genes in the prefrontal cortex, hippocampus and amygdala. We found that the long-term alcohol consumption of an individual could be estimated by the mean of its consumption on Day 2 and 3. This short exposure minimized changes in gene expression induced by alcohol itself. We found a positive correlation in the prefrontal cortex of GABAA α5 (r = 0.96), GABAB1 (r = 0.96), AMPA GluR1 (r = 0.93), 5-HT3A (r = 0.93) and the α adrenoceptors (α1A r = 1.00, α1B r = 0.93, α2A r = 0.93) with consumption. In the hippocampus, we found negative correlations with the NMDA NR2A subunit (r = − 0.86), the α1A adrenoceptor (r = − 0.89) and the glucocorticoid receptor (r = − 0.86). Finally, in the amygdala there was a negative correlation to NMDA NR2A (r = − 0.79) and a positive correlation with serotonin 5-HT2C (r = 0.79). In conclusion, we have used qPCR to identify specific genes in the brain that correlated to alcohol self-administration of an individual animal. This study suggests that alcohol consumption in the early stages of acquisition depends on the genetic background of the individual and that the prefrontal cortex is particularly important in this behaviour.
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| 32. |
- Pickering, Chris, et al.
(författare)
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The role of hypothalamic peptide gene expression in alcohol self-administration behavior.
- 2007
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Ingår i: Peptides. - : Elsevier BV. - 0196-9781 .- 1873-5169. ; 28:12, s. 2361-2371
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Tidskriftsartikel (refereegranskat)abstract
- Self-administration of ethanol and food share many common features and Richter hypothesized that an increase in ethanol consumption would decrease feeding to balance the excess calories contained in the ethanol. Previously, we have shown that individual alcohol consumption correlates with neurotransmitter gene expression, especially in the prefrontal cortex. To test the hypothesis of Richter, we measured hypothalamic gene expression of receptors or neuropeptides of known relevance for the regulation of food intake using qPCR and correlated this to individual ethanol consumption in Wistar rats. For validation, gene expression was first correlated with body weight. We found a correlation of dynorphin, somatostatin, melanocortin-4 receptor and serotonin 5-HT2C with body weight and trends to correlation for CART, thus confirming the established role of the hypothalamus in the regulation of weight. For ethanol consumption, correlations were found for CRH receptors I and 2 and vasopressin while strong trends were observed for galanin receptor 1, orexin receptor 1, MCH and adrenoceptor alpha(1B). Therefore, alcohol consumption does seem to involve several hypothalamic systems which also mediate feeding responses and suggests that the hypothalamus, together with the prefrontal cortex, may determine the 'stopping point' of an individual.
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| 33. |
- Pickering, Chris, et al.
(författare)
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To press or not to press? Differential receptor expression and response to novelty in rats learning an operant response for reward
- 2007
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Ingår i: Neurobiology of Learning and Memory. - : Elsevier BV. - 1074-7427 .- 1095-9564. ; 87:2, s. 181-191
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Tidskriftsartikel (refereegranskat)abstract
- Learning to perform instrumental tasks is an ability of all animals. In a population of rats, not all individuals will acquire an operant response for reward. We hypothesized that there could be a genetic explanation for differences between High Consumers (those that acquired the lever press response) and Low Consumers (lever press response is low). Additionally, we proposed that this genetic difference could produce measurable changes in response to novelty. Wistar rats were trained to lever press for a 0.2% saccharin reward and on the 10th day they were placed in a novel open field for 30 min to record locomotor activity. The prefrontal cortex and hippocampus were dissected and qPCR was used to measure mRNA expression. A significant difference (p=.048; 2-way ANOVA) in gene expression was observed between Low and High Consumers. A principal component analysis (PCA), to cluster which genes represent this difference, identified 4 genes; 5-HT2A and mGlu1 in the hippocampus and AMPA GluR1 and adrenergic alpha2A in the prefrontal cortex. Response to a novel open field also differed since Low Consumers displayed a higher Total Distance in comparison to High Consumers. Additionally, Low Consumers could be subdivided into Low-Lever (with lever press response only when water deprived) and Low-Non-Lever (lever press response is low throughout training). PCA with this subdivision identified an additional nine genes differing within the divisions; NMDA NR2B and GABAAalpha3 in the prefrontal cortex and adrenergic alpha2B and alpha2A, AMPA GluR1, GluR2 and GluR3, 5-HT1B and GABAAalpha5 in the hippocampus.
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- Stjärne Aspelund, A., et al.
(författare)
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Acetic acid as a decontamination method for sink drains in a nosocomial outbreak of metallo-β-lactamase-producing Pseudomonas aeruginosa
- 2016
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Ingår i: Journal of Hospital Infection. - : Elsevier BV. - 0195-6701. ; 94:1, s. 13-20
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Tidskriftsartikel (refereegranskat)abstract
- Background Pseudomonas aeruginosa may colonize water systems via biofilm formation. In hospital environments, contaminated sinks have been associated with nosocomial transmission. Here we describe a prolonged outbreak of a metallo-β-lactamase-producing P. aeruginosa (Pae-MBL) associated with sink drains, and propose a previously unreported decontamination method with acetic acid. Aim To describe a nosocomial outbreak of Pae-MBL associated with hospital sink drains and to evaluate acetic acid as a decontamination method. Methods The outbreak was investigated by searching the microbiology database, microbiological sampling and strain typing. Antibacterial and antibiofilm properties of acetic acid were evaluated in vitro. Pae-MBL-positive sinks were treated with 24% acetic acid once weekly and monitored with repeated cultures. Findings Fourteen patients with positive cultures for Pae-MBL were identified from 2008 to 2014. The patients had been admitted to three wards, where screening discovered Pae-MBL in 12 sink drains located in the patient bathrooms. Typing of clinical and sink drain isolates revealed identical or closely related strains. Pae-MBL biofilm was highly sensitive to acetic acid with a minimum biofilm eradication concentration of 0.75% (range: 0.19–1.5). Weekly treatment of colonized sink drains with acetic acid resulted in negative cultures and terminated transmission. Conclusion Acetic acid is highly effective against Pae-MBL biofilms, and may be used as a simple method to decontaminate sink drains and to prevent nosocomial transmission.
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- Söderblom, T., et al.
(författare)
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Alarming spread of vancomycin resistant enterococci in Sweden since 2007
- 2010
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Ingår i: Eurosurveillance. - 1025-496X .- 1560-7917. ; 15:29
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Tidskriftsartikel (refereegranskat)abstract
- The total number of persons infected or colonised with vancomycin-resistant enterococci mandatorily reported to the Swedish Institute for Infectious Disease Control increased dramatically during 2007 and 2008. During a period of twenty months from 1 July 2007 to 28 February 2009, a total of 760 cases were reported compared with 194 cases reported during the entire period from 2000 to 2006. This rise was mainly attributed to a wide dissemination of vancomycin resistant enterococci which started in a number of hospitals in Stockholm in the autumn of 2007 and was followed by dissemination in various healthcare facilities (hospitals and homes for the elderly) in a further two Swedish counties in 2008. The majority of the cases (97%) were acquired in Sweden and among these, healthcare-acquired E. faecium vanB dominated (n=634). The majority of these isolates had identical or closely related pulsed-field gel electrophoresis patterns indicating clonal dissemination in the affected counties. The median minimum inhibitory concentration of vancomycin was 32 mg/L (ranging from 4 to > 128 mg/L) and of teichoplanin 0.12 mg/L (ranging from 0.06 to 0.25 mg/L). Particular emphasis was placed on countermeasures such as screening, contact tracing, cleaning procedures, education in accurate use of infection control practices as well as increasing awareness of hygiene among patients and visitors. With these measures the dissemination rate decreased substantially, but new infections with the E. faecium vanB strain were still detected.
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- Walther, Sten, et al.
(författare)
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Antibiotic prescription practices, consumption and bacterial resistance in a cross section of Swedish intensive care units
- 2002
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172. ; 46:9, s. 1075-1081
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of this work was to study usage of antibiotics, its possible determinants, and patterns of bacterial resistance in Swedish intensive care units (ICUs). Methods: Prospectively collected data on species and antibiotic resistance of clinical isolates and antibiotic consumption specific to each ICU in 1999 were analyzed together with answers to a questionnaire. Antibiotic usage was measured as defined daily doses per 1000 occupied bed days (DDD1000). Results: Data were obtained for 38 ICUs providing services to a population of approximately 6 million. The median antibiotic consumption was 1257 DDD1000 (range 584–2415) and correlated with the length of stay but not with the illness severity score or the ICU category. Antibiotic consumption was higher in the ICUs lacking bedside devices for hand disinfection (2193 vs. 1214 DDD1000, p=0.05). In the ICUs with a specialist in infectious diseases responsible for antibiotic treatment the consumption pattern was different only for use of glycopeptides (58% lower usage than in other ICUs: 26 vs. 11 DDD1000,P=0.02). Only 21% of the ICUs had a written guideline on the use of antibiotics, 57% received information on antibiotic usage at least every 3 months and 22% received aggregated resistance data annually. Clinically significant antimicrobial resistance was found among Enterbacter spp. to cephalosporins and among Enterococcus spp. to ampicillin. Conclusions: Availability of hand disinfection equipment at each bed and a specialist in infectious diseases responsible for antibiotic treatment were factors that correlated with lower antibiotic consumption in Swedish ICUs, whereas patient-related factors were not associated with antibiotic usage.
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