Antimicrobial resistance in Streptococcus pneumoniae, Streptococcus pyogenes and Escherichia coli from the Faroese population, correlation with antimicrobial use and comparison with Iceland and Denmark

• Main Author: Debess Magnussen, Marita
• Other Authors: Karl G. Kristinsson, Læknadeild (HÍ), Faculty of Medicine (UI), Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), Háskóli Íslands, University of Iceland
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: University of Iceland, School of Health Sciences, Faculty of Medicine 2018
• Subjects: Faroe Islands; Iceland; Antibacterial sale; Antibacterial resistance; Pneumococcal serotypes; E. coli; Streptococcus pyogenes; Færeyjar; Ísland; Bakteríusjúkdómar; Bólusetningar; Bóluefni; Öndunarfærasjúkdómar; Doktorsritgerðir; Faroes
• Online Access: https://hdl.handle.net/20.500.11815/913

The geographic remoteness of the Faroe Islands makes the archipelago an ideal location for research on bacterial carriage, their clonality, and vaccine studies. However, previous studies are lacking and the limited availability of necessary data has limited such investigations. The novel data collection and analysis presented in this thesis provides valuable knowledge on the antibacterial resistances in the three human bacterial pathogens - Group A Streptococcus (GAS), Escherichia coli and pneumococci in the Faroes. Data on antibacterial sales were compiled from the National Pharmacist in the Faroe Islands, Icelandic Medicines Agency, NOMESCO and DANMAP. Clinical oropharynx and urine samples were collected from patients by general practitioners in the years 2009, 2010 and in 2012. Nasopharyngeal swabs were collected from healthy children attending day-care centres from January to March in 2009, 2010 and 2011. Invasive pneumococcal isolates from the Faroe Islands were obtained from Statens Serum Institut in Denmark. All samples were identified and pneumococcal isolates were serotyped in two laboratories, one in the Faroe Islands and one in Iceland. Susceptibility testing was done according to CLSI and EUCAST standards using conventional methods. During the period 1999 to 2011, antibacterial sales were highest in Iceland, followed by the Faroe Islands and Denmark – with 21.8, 17.7 and 16.3 daily defined dose (DDD)/1000 inhabitants/day (DID), respectively. The most noteworthy difference was the higher sales of tetracycline in Iceland. The sales of the sub-groups, penicillins and macrolides differed significantly between the three countries. Erythromycin was mainly prescribed to children aged 0-4 years in the Faroe Island. Among GAS isolates from Faroese patients, the resistance of tetracycline decreased markedly between 2009 and 2010 (37% to 10%) and erythromycin resistance dropped in Iceland from 2008 (44%) to 2009 (5%). In the Faroe Islands, non-susceptibility was found in 54% of E. coli isolates with ...