I denna presentation redovisar Folkhlsomyndigheten humandata frn Swedres

I denna presentation redovisar Folkhälsomyndigheten humandata från Swedres. Svarm 2014. Använd gärna dessa figurer och tabeller i egna presentationer. Vi är tacksamma om källan anges. För flertalet figurer kan bakgrundsdata öppnas i Excel, så att presentationen kan anpassas. Genom att klicka på fliken Visa och välja dispositionsvy hittar du lätt den figur du letar efter. Bild 3 -42 från kapitel: Consumption of antimicrobials Bild 43 -82 från kapitel: Antibiotic resistance Bild 83 -88 från kapitel: Background data, material, metods and references Sid 2. 2021 -09 -08

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 J 01 exclusive J 01 XX 05 Total 14. 5 14. 7 14. 4 14. 1 14. 6 15. 0 15. 4 15. 2 14. 4 14. 3 14. 5 14. 2 13. 4 12. 8 J 01 exclusive J 01 XX 05 Outpatient care 13. 1 13. 3 13. 0 12. 8 12. 6 13. 0 13. 3 13. 7 13. 5 12. 8 12. 7 12. 8 12. 5 11. 7 11. 2 J 01 exclusive J 01 XX 05 Hospital care 1. 18 1. 22 1. 25 1. 33 1. 36 1. 43 1. 49 1. 55 1. 52 1. 48 1. 52 1. 59 1. 63 1. 60 J 01 XX 05 Total 1. 56 1. 55 1. 64 1. 72 1. 86 1. 88 1. 81 1. 6 1. 43 1. 33 1. 28 1. 27 1. 24 1. 22 J 01 XX 05 Outpatient care 1. 48 1. 49 1. 67 1. 78 1. 81 1. 74 1. 55 1. 40 1. 30 1. 26 1. 25 1. 22 1. 20 J 01 XX 05 Hospital care 0. 03 0. 05 0. 07 0. 05 0. 03 0. 02 J 01 Total 16. 1 16. 3 16. 1 16. 0 16. 5 16. 9 17. 3 16. 8 15. 7 15. 5 14. 7 14. 1 J 01 Outpatient care 14. 6 14. 8 14. 6 14. 5 14. 3 14. 8 15. 1 15. 4 15. 1 14. 2 14. 0 13. 8 13. 0 12. 4 J 01 Hospital care 1. 21 1. 25 1. 27 1. 37 1. 43 1. 5. 0 1. 56 1. 62 1. 57 1. 52 1. 55 1. 61 1. 65 1. 62 Table 1. 1. Sid 3. 2021 -09 -08

Sid 4. 2021 -09 -08 Figure 1. 1. Go nd la nd e in g la an st m ta Gö ro eb ek Bl e ån a tl Kr and on Sö ob de e rm rg an la Vä nd rm la nd Ha lla Ös nd te rg öt la nd Ka l No ma r rr bo tte n Da la Gä rna Vä vle bo st r er no g r rla Vä nd st er bo t Jö ten nk öp in g Jä m tla nd Vä ra st Vä Ör Sk al m ol ps Up kh oc St DDD/1000 inhabitants and day 16 14 12 10 8 6 4 2 0 Outpatient care Hospital care Källa: Folkhälsomyndigheten 2015

Carbapenems (J 01 DH) Outpatient care Trimethoprim (J 01 EA) Hospital care Cephalosporins (J 01 DB-DE) Macrolides (J 01 FA) Trimethoprim with sulphonamides (J 01 EE) Combinations of penicillins (J 01 CR) Lincosamides (J 01 FF) Nitrofurantoin (J 01 XE) Pivmecillinam (J 01 CA 08) Fluoroquinolones (J 01 MA) Penicillins with extended spectrum (J 01 CA) excl. pivmecillinam (J 01 CA 08) Betalactamase-resistant penicillins (J 01 CF) Tetracyclines (J 01 A) Betalactamase sensitive penicillins (J 01 CE) 0 1 2 3 DDD/1000 inhabitants and day Figure 1. 2. Sid 5. 2021 -09 -08 4

Sid 6. 2021 -09 -08 Figure 1. 3. 87 0 -4 5 - 14 95 19 96 19 97 19 98 19 99 20 00 20 01 20 02 20 03 20 04 20 05 20 06 20 07 20 08 20 09 20 10 20 11 20 12 20 13 20 14 19 93 19 92 19 91 19 90 19 89 19 88 19 19 Prescriptions/1000 inhabitants and year 1400 1200 1000 800 600 400 200 0 15 - 64 65* All age groups Källa: Folkhälsomyndigheten 2015

J 0 1 C A- Sid 7. 2021 -09 -08 Figure 1. 4. X 1 X J 0 ls ria te ac ib an t in s ne es to an ur of itr -N lo no id es id ol m sa ui oq or lu er th E 1 X -F -O J 0 A co in -L ac r 2013 1 M F -M es id am ho n im pr ho in s 2012 1 F A 1 F lp su et rim -T or 2011 J 0 w ith A sp lo llin s s 2010 J 0 im 1 E ha ep -C en ici of p llin s lin cil ni en ici tp pe m na illi ec 8 A 0 1 C ne s 2009 J 0 pr ho et -T rim J 0 DE 01 -J ns tio na bi om an ist ve iti ns es -r se J 0 m iv -P cl. ex cli cy ra et -T Prescriptions /1000 inhabitants and year 2008 E B 1 D J 0 -C as e am ac t R 1 C J 0 al et -B 8 A 0 1 C as e ta m ac J 0 tru m ec sp A 1 A J 0 2007 1 E F 1 C ed nd al et -B te ex 2005 J 0 E w ith 1 C J 0 s llin Pe ni ci 2000 2014 160, 0 140, 0 120, 0 100, 0 80, 0 60, 0 40, 0 20, 0 Källa: Folkhälsomyndigheten 2015

800 25 700 20 500 15 400 10 300 200 5 100 0 0 0 -4 years 5 -9 years 10 -14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 70 - 74 75 - 79 80 - 84 85 - 89 years years years years Prescriptions / 1000 inhabitants Figure 1. 5 Sid 8. 2021 -09 -08 DDD / 1000 inhabitants and day 90 years DDD 71000 inhabitants and day Prescriptions/1000 inhabitants 600

300000 250000 Prescriptions 200000 150000 100000 50000 0 0 -4 years 5 -9 years 10 -14 15 - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 70 - 74 75 - 79 80 - 84 85 - 89 90 years years years years years Antibiotics commonly used to treat respiratory tract infections Antibiotics commonly used to treat urinary tract infections Antibiotics commonly used to treat skin and soft tissue infections Figure 1. 6. Sid 9. 2021 -09 -08

0 Sid 10. 2021 -09 -08 Figure 1. 7. Antibiotics commonly used to to treat respiratory tract infections urinary tract infections skin and soft tissue infections acne 90 - years 85 - 89 years 80 - 84 years 75 - 79 years 70 - 74 years 65 - 69 years 60 - 64 years 55 - 59 years 50 - 54 years 45 - 49 years 40 - 44 years 35 - 39 years 30 - 34 years 25 - 29 years 20 - 24 years 15 - 19 years 10 -14 years 5 -9 years 0 - 4 years Prescriptions/1000 inhabitants 800 700 600 500 400 300 200 100

160 Prescriptions/1000 inhabitants and year 140 120 100 80 60 40 2001 2002 2003 2004 2005 Figure 1. 8. 2007 2008 2009 2010 2011 2012 Penicillin V (J 01 CE 02) Doxycycline (J 01 AA 02)* Amoxicillin (J 01 CA 04) Cephalosporines (J 01 DB-DE) Macrolides (J 01 FA) Amoxicillin with clavulanic acid (J 01 CR 02) * Excluding packages containing more than 50 tablets Sid 11. 2021 -09 -08 2006 2013 2014

250 Prescriptions/1000 inhabitants 200 150 100 50 0 0 -6 years Doxycyclinje (J 01 AA 02)* Amoxicillin with clavulanic acid (J 01 CR 02) 7 -19 years Amoxicillin (J 01 CA 04) Macrolides (J 01 FA) * Excluding packages containing more than 50 tablets Figure 1. 9. Sid 12. 2021 -09 -08 20 -64 years 65 years and older Penicillin V (J 01 CE 02) Cephalosporines (J 01 DB-DE)

Sid 13. 2021 -09 -08 Figure 1. 10. 13 20 12 20 11 20 14 /2 0 13 /2 0 12 11 /2 0 10 /2 0 09 /2 0 10 20 09 20 08 /2 0 07 /2 0 06 05 04 /2 0 03 /2 0 07 20 1 02 /2 0 06 20 05 20 04 20 03 20 02 20 01 20 00 /2 00 20 Percent (DDD per 1000 inhabitants and per day (winter quarters)/DDD per 1000 inhabitants and per day (summer quarters)-1] x 100) 25 20 15 10 5 0

80 70 Prescriptions/1000 women and year 60 50 40 30 20 10 0 2001 2002 2003 Pivmecillinam (J 01 CA 08) Fluoroquinolones (J 01 MA 02+06) Figure 1. 11. Sid 14. 2021 -09 -08 2004 2005 2006 2007 2008 Nitrofurantoin (J 01 XE) Trimethoprim (J 01 EA) 2009 2010 2011 2012 2013 2014

140 Prescriptions/1000 men and year 120 100 80 60 40 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Fluoroquinolones (J 01 MA 02+06) Pivmecillinam (J 01 CA 08) Nitrofurantoin (J 01 XE 01) Trimethoprim with sulphonamides (J 01 EE) Trimethoprim (J 01 EA 01) Figure 1. 12. Sid 15. 2021 -09 -08 2013 2014

Sid 16. 2021 -09 -08 Figure 1. 13. 2007 de a al ed en rm Vä an la st nd ra Gö ta la Vä nd st m an la nd Bl ek in ge Ör eb Ös ro te rg öt la nd Ha lla nd Kr on ob er g Jö nk öp in g Vä rm la nd Go tla nd Ka lm ar Gä vl eb Vä or st g er no rr la nd Da la rn No a rr bo tte Vä n st er bo tte n Jä m tla nd Sö Sw e m ån ps Up Sk ol kh oc St Prescriptions/1000 children and year 900 800 700 600 500 400 300 200 100 0 2008 2009 2010 2011 2012 2013 2014

J 0 A 1 C Sid 17. 2021 -09 -08 Figure 1. 14. 2000 2005 2007 2008 2009 2010 2011 2012 he r Ot 2013 2014 01 AA , 8, A 0 1 C J 0 1 F J 0 F -M d an J 0 1 M n A) to i an lid es ro ac itr of ur -N A id es m na ho su lp rim ho p et in s lin s cil llin s po r ha lo s ni pe pe ni ci s llin i. . . m ec ni ci pe pi v -T rim 1 F ith w 1 X E J 0 rim of ep -C A 1 E DE J 0 01 -J ho p et -T rim B ns tio na bi om nt ta sis e iv cl. ex sit se n ere as ta m e as m tru sp ec m ta -C 1 D J 0 R 1 C J 0 et al ac -B (J E 1 E J 0 1 C F J 0 et al ac ed nd te ex -B ith w 1 C E J 0 s lin ici l en -P Prescriptions/1000 children and year 450 400 350 300 250 200 150 100 50 0

2012 Figure 1. 15. Sid 18. 2021 -09 -08 2013 2014

2013 2014 Källa: Folkhälsomyndigheten 2015 Sid 19. 2021 -09 -08

Sid 20. 2021 -09 -08 Figure 1. 17. de e lla nd rm an la Ös nd te rg öt la nd Ka lm ar Kr on ob er g Ör eb ro Vä rm la nd Jö nk Vä öp st in er g no rr la nd No rr bo tte n Da la rn a Gä vl eb or g Jä m t la Vä nd st er bo tte n Sö Ha in g nd la nd en nd la ek Bl ta Gö an tla Go ed a al e lm ån ps Sw st m ra st Vä Vä Sk ho ck Up St o Prescriptions/1000 inhabitants and year 450 400 350 300 250 200 150 100 50 0 2012 2013 2014

Sid 21. 2021 -09 -08 Figure 1. 18. de Gö t a en ed al al an d rm an la nd Bl ek in Ös ge te rg öt la nd Kr on ob er g Ha lla nd Go tla Vä nd st m an la nd Ka lm ar Ör eb ro Jö nk öp in g Vä rm la nd Da Vä la st rn er no a rr la nd No rr bo tte Gä n vl eb or g Jä m tla Vä nd st er bo tte n Sö ra st Vä Sw e m ån ps Up Sk ol kh oc St Prescriptions/1000 inhabitants 250 200 150 100 50 0 Antibiotics commonly used to treat SSTI Antibiotics commonly used to treat RTI Antibiotics commonly used to treat UTI Other antibiotics

Värmland Västmanland Jönköping Blekinge Dalarna Kalmar Västernorrland Västerbotten Örebro Västra Götaland Gävleborg Östergötland Skåne Jämtland Norrbotten Sweden Halland Södermanland Gotland Uppsala Stockholm Kronoberg 0% 10% 20% 30% 40% 2014 Figure 1. 19. Sid 22. 2021 -09 -08 50% 2013 60% 70% 80% 90% 100%

Östergötland Kalmar Västra Götaland Värmland Stockholm Dalarna Jönköping Jämtland Uppsala Gotland Sweden Västmanland Skåne Norrbotten Blekinge Gävleborg Södermanland Kronoberg Örebro Västerbotten Halland Västernorrland 0% 10% 20% 30% 40% 2014 Figure 1. 20. Sid 23. 2021 -09 -08 50% 2013 60% 70% 80% 90% 100%

35 30 Prescriptions/1000 inhabitants 25 20 15 10 5 0 2009 Penicillin V (J 01 CE 02) Metronidazol (P 01 AB 01) Figure 1. 21. Sid 24. 2021 -09 -08 2010 Amoxicillin (J 01 CA 04) Other (in the group J 01) 2011 2012 Clindamycin (J 01 FF 01) Erytromycin (J 01 FA 01) 2013 2014

Sid 25. 2021 -09 -08 Figure 1. 22. 2011 2012 2013 2014 n n tte ro eb bo er st Vä Ör te ot d rg bo rrl an rrb No no st er Vä d g er nd la n rm vle Gä Vä a nd tla ob on Kr Go lla Ha rn la Da a ng pi kö al ps d ar ta la n Up Gö 2010 lm 2009 Jö n ra st Ka Vä ge in ek Bl nd nd la tla Jä m d la n an nd e ån la rg öt te Ös st m Vä Sk rm an de Sö m ol kh oc St Perscriptions/ 1000 inhabitants 40 35 30 25 20 15 10 5 0

Period 1 Period 4 Decrease 1 Oct 2010 -30 Sep 2011 Prescriptions/1000 inhabitants 1 Oct 2013 -30 Sep 2014 Prescriptions/1000 inhabitants Prescriptions Per cent Stockholm 413 356 -57 -14% Skåne 411 351 -60 -15% Uppsala 374 336 -38 -10% Gotland 380 327 -53 -14% Sweden 381 325 -56 -15% Västra Götaland 399 320 -79 -20% Halland 381 320 -61 -16% Blekinge 388 316 -72 -19% Västmanland 366 316 -50 -14% Södermanland 345 314 -31 -9% Östergötland 352 314 -38 -11% Kalmar 359 312 -47 -13% Kronoberg 370 305 -65 -18% Örebro 336 302 -34 -10% Västernorrland 329 299 -30 -9% Värmland 346 298 -48 -14% Norrbotten 349 298 -51 -15% Jönköping 355 296 -59 -17% Dalarna 313 288 -25 -8% Gävleborg 337 286 -51 -15% Jämtland 307 272 -35 -11% Västerbotten 310 261 -49 -16% Källa: Folkhälsomyndigheten 2015 Table A, In focus National campaign for improved national safety Sid 26. 2021 -09 -08

Period 1 Period 4 Diff% 1 Oct 2010 -30 Sep 2011 1 Oct 2013 -30 Sep 2014 Penicillin V (J 01 CE 02) 116. 7 92. 1 -24. 7 -21% Flucloxacillin (J 01 CF 05) 40. 3 38. 4 -1. 8 -5% Pivmecillinam (J 01 CA 08) 33. 1 33. 7 0. 6 2% Doxycycline (J 01 AA 02) 39. 6 28. 6 -11. 0 -28% Nitrofurantoin (J 01 XE 01) 22. 5 24. 8 2. 3 10% Ciprofloxacin (J 01 MA 02) 24. 0 22. 3 -1. 7 -7% Amoxicillin (J 01 CA 04) 24. 4 18. 3 -6. 2 -25% Clindamycin (J 01 FF 01) 15. 9 14. 9 -0. 9 -6% Lymecycline (J 01 AA 04) 10. 2 10. 0 -0. 2 -1% Cefadroxil (J 01 DB 05) 11. 0 8. 2 -2. 8 -25% Trimethoprim (J 01 EA 01) 11. 6 7. 4 -4. 2 -36% Sulfamethoxazole and trimethoprim (J 01 EE 01) 6. 2 6. 1 -0. 1 -2% Amoxicillin and enzyme inhibitor (J 01 CR 02) 6. 1 5. 8 -0. 3 -5% Erytromycine (J 01 FA 01) 8. 4 5. 3 -3. 1 -37% Azitromycine (J 01 FA 10) 2. 1 2. 7 0. 5 24% Källa: Folkhälsomyndigheten 2015 Table B, In focus National campaign for improved national safety Sid 27. 2021 -09 -08

700 600 Prescriptions/1000 inhabitants 500 400 1 Oct 2009 -30 Sep 2010 1 Oct 2010 -30 Sep 2011 1 Oct 2011 -30 Sep 2012 300 1 Oct 2012 -30 Sep 2013 1 Oct 2013 -30 Sep 2014 200 100 0 Sweden Norway Finland Figure A, In focus National campaign for improved national safety Sid 28. 2021 -09 -08 Danmark

16 14 DDD/100 patient-days 12 10 8 6 4 2 0 2010 *Includes all sales on requisition Figure 1. 23. Sid 29. 2021 -09 -08 2011 2012 Betalactamase resitant penicillins (J 01 CF) Betalactamase sensitive penicillins (J 01 CE) Fluoroquinolones (J 01 MA) Cephalosporins (J 01 DB-DE) Combinations of penicillins (J 01 CR) Carbapenems (J 01 DH)* 2013 2014

2010 2011 2012 2013 2014* Tetracyclines (J 01 AA) 4. 6 5. 0 5. 3 5. 4 Penicillins with extended spectrum (J 01 CA) 6. 0 6. 5 6. 9 7. 5 7. 7 Betalactamase sensitive penicillins (J 01 CE) 6. 7 7. 2 7. 6 7. 5 Betalactamase resitant penicillins (J 01 CF) 10. 9 11. 3 12. 0 13. 1 13. 5 Combinations of penicillins (J 01 CR) 3. 3 3. 8 4. 4 5. 5 5. 9 Cephalosporins (J 01 DB-DE) 7. 1 6. 8 6. 7 7. 1 6. 8 Carbapenems (J 01 DH)** 2. 5 2. 6 2. 7 3. 0 3. 1 Trimethoprim (J 01 EA) 0. 9 0. 8 0. 6 0. 5 0. 4 Trimethoprim with sulphonamides (J 01 EE) 2. 1 2. 3 2. 5 Macrolides (J 01 FA) 0. 9 1. 1 1. 0 Lincosamides (J 01 FF) 1. 7 1. 9 2. 1 2. 0 Aminoglycosides (J 01 GB) 1. 1 1. 2 1. 3 Fluoroquinolones (J 01 MA) 6. 1 6. 2 6. 3 6. 6 6. 9 Glycopeptides (J 01 XA) 0. 8 0. 9 1. 0 Imidazole derivatives (J 01 XD) 1. 3 1. 2 1. 1 1. 3 1. 1 Nitrofurantoin (J 01 XE) 0. 4 0. 5 0. 6 Methenamine (J 01 XX 05) 0. 6 0. 5 0. 6 Linezolid (J 01 XX 08) 0. 1 0. 1 All agents (J 01) 57. 4 59. 8 62. 9 67. 2 68. 2 *Denominator data from 2013. ** Includes all sales on requisition Table 1. 3. Sid 30. 2021 -09 -08 Källa: Folkhälsomyndigheten 2015

2010 2011 2012 2013 2014* Tetracyclines (J 01 AA) 21. 5 22. 7 23. 4 24. 1 24. 0 Penicillins with extended spectrum (J 01 CA) 28. 0 29. 5 30. 6 33. 3 34. 0 Betalactamase sensitive penicillins (J 01 CE) Betalactamase resitant penicillins (J 01 CF) Combinations of penicillins (J 01 CR) Cephalosporins (J 01 DB-DE) Carbapenems (J 01 DH)** Trimethoprim (J 01 EA) Trimethoprim with sulphonamides (J 01 EE) Macrolides (J 01 FA) Lincosamides (J 01 FF) Aminoglycosides (J 01 GB) Fluoroquinolones (J 01 MA) Glycopeptides (J 01 XA) Imidazole derivatives (J 01 XD) Nitrofurantoin (J 01 XE) Methenamine (J 01 XX 05) Linezolid (J 01 XX 08) All agents (J 01) 31. 3 51. 0 15. 6 33. 3 11. 9 4. 0 9. 9 4. 1 7. 9 5. 0 28. 3 3. 7 6. 0 2. 7 0. 4 267. 5 32. 8 51. 4 17. 4 31. 1 11. 9 3. 6 10. 3 4. 9 7. 9 5. 3 28. 3 4. 1 5. 4 2. 1 2. 5 0. 3 273. 2 33. 8 53. 4 19. 5 29. 9 12. 2 2. 7 10. 2 4. 2 8. 4 5. 7 28. 1 4. 1 5. 1 2. 1 0. 4 278. 9 33. 5 58. 2 24. 4 31. 7 13. 5 2. 1 11. 0 4. 5 9. 1 5. 4 29. 2 4. 5 5. 7 2. 4 2. 5 0. 5 298. 1 33. 2 59. 9 26. 2 30. 2 13. 9 11. 0 4. 4 8. 8 5. 6 30. 4 4. 5 4. 7 2. 5 2. 6 0. 6 302. 2 *Denominator data from 2013. ** Includes all sales on requisition Table 1. 4. Sid 31. 2021 -09 -08 Källa: Folkhälsomyndigheten 2015

Värmland Jönköping Västmanland Norrbotten Jämtland Västra Götaland Västernorrland Gotland Södermanland Skåne Halland Kalmar Örebro Dalarna Blekinge Västerbotten Kronoberg Gävleborg Stockholm Östergötland Uppsala 0% Figure 1. 24. Sid 32. 2021 -09 -08 10% 20% 30% 40% 50% DDD 60% 70% 80% 90% 100%

Piperacillin with tazobactam (J 01 CR 05) Carbapenems (J 01 DH)* Fluoroquinolons (J 01 MA) Cephalosporins (J 01 DBDE) 2013 2014 Södermanland 7. 8% 9. 0% 2. 7% 2. 4% 14. 6% 15. 0% Stockholm 5. 7% 6. 0% 4. 6% 4. 4% 9. 9% 9. 8% Östergötland 4. 9% 5. 5% 4. 3% 4. 5% 9. 1% 8. 6% Skåne 5. 0% 5. 7% 2. 8% 8. 9% Västra Götaland 6. 9% 7. 5% 2. 6% 3. 3% 8. 9% Kalmar 11. 3% 13. 1% 5. 6% 5. 9% Norrbotten 7. 7% 8. 7% 4. 2% 4. 8% Gotland 4. 9% 7. 0% 4. 8% Jönköping 1. 7% 7. 8% Värmland 6. 3% 6. 7% Örebro 6. 2% Halland 4. 7% Kronoberg 2014 2013 2014 3. 9% 3. 3% 29. 3% 28. 6% 11. 1% 11. 0% 29. 1% 28. 8% 16. 1% 15. 7% 27. 6% 29. 2% 9. 1% 11. 3% 11. 5% 27. 9% 30. 0% 8. 8% 8. 7% 8. 2% 30. 4% 9. 5% 9. 1% 6. 6% 10. 0% 28. 4% 30. 8% 8. 5% 7. 1% 7. 5% 29. 5% 31. 1% 3. 9% 9. 1% 8. 5% 8. 7% 9. 5% 31. 1% 31. 2% 4. 0% 3. 6% 10. 2% 16. 8% 9. 9% 31. 4% 31. 3% 3. 3% 2. 9% 9. 4% 10. 9% 10. 0% 29. 7% 31. 4% 8. 1% 3. 9% 3. 4% 12. 0% 11. 4% 10. 3% 9. 1% 31. 9% 31. 4% 5. 7% 3. 1% 3. 5% 9. 4% 10. 8% 11. 0% 10. 8% 25. 1% 31. 4% 5. 9% 6. 9% 2. 6% 4. 0% 13. 4% 11. 8% 10. 6% 30. 3% 32. 1% Uppsala 8. 6% 9. 4% 3. 8% 3. 6% 10. 3% 10. 8% 10. 7% 9. 9% 32. 3% 32. 2% Västerbotten 6. 1% 5. 7% 4. 9% 4. 4% 10. 6% 10. 3% 11. 3% 12. 0% 32. 4% Blekinge 6. 2% 6. 9% 5. 8% 5. 6% 10. 3% 11. 3% 10. 9% 32. 4% Västmanland 6. 8% 7. 7% 3. 6% 3. 7% 12. 7% 3. 4% 6. 9% 7. 3% 32. 8% 33. 3% Västernorrland 5. 8% 6. 7% 3. 0% 4. 0% 11. 9% 12. 5% 11. 6% 10. 4% 34. 6% 33. 8% Jämtland 6. 6% 7. 9% 3. 6% 3. 2% 11. 4% 10. 8% 9. 5% 8. 5% 34. 7% 34. 1% Dalarna 4. 9% 5. 9% 4. 8% 6. 1% 11. 7% 11. 9% 10. 6% 10. 2% 34. 4% 36. 2% Gävleborg 7. 6% 8. 2% 8. 0% 7. 8% 11. 3% 10. 6% 12. 7% 11. 1% 38. 1% 37. 6% * Includes all sales on requisition Table 1. 5. Sid 33. 2021 -09 -08 2013 All broad spectrum agents Källa: Folkhälsomyndigheten 2015

Värmland Västra Götaland Norrbotten Fluoroquinolons (J 01 MA) Cephalosporins (J 01 DB-DE) Piperacillin with tazobactam (J 01 CR 05) Carbapenems (J 01 DH)* Halland Jämtland Gotland Skåne Södermanland Kalmar Västmanland Västerbotten Jönköping Blekinge Örebro Dalarna Stockholm Västernorrland Gävleborg Kronoberg Uppsala Östergötland 0% 10% 20% 30% * Includes all salens on requisition Figure 1. 25. Sid 34. 2021 -09 -08 40% DDD 50% 60% 70% 80% 90% 100%

0, 35 DDD/1000 inhabitants and day 0, 30 0, 25 0, 20 0, 15 0, 10 0, 05 0, 00 2001 2002 2003 2004 2005 Beta-lactamase resistant penicillins (J 01 CF) Fluoroquinolones (J 01 MA) Combinations of penicillins (J 01 CR) Aminoglycosides (J 01 GB) * Includes all sales on requisition Figure 1. 26. Sid 35. 2021 -09 -08 2006 2007 2008 2009 2010 2011 2012 2013 Beta-lactamase sensitive penicillins (J 01 CE) Cephalosporins (J 01 DB-DE) Carbapenems (J 01 DH)* Vancomycin (J 01 XA 01) 2014

Number of patient treated with antibioitcs for the indication UTI without fever 25 Start of intervention 20 15 10 5 0 2013 -Q 3 2013 -Q 4 Figure A, In focus, A national IT tool for surveilliance Sid 36. 2021 -09 -08 2014 -Q 1 2014 -Q 2 2014 -Q 3 2014 -Q 4

Sid 37. 2021 -09 -08 illi n ra c pe Pi llin ox ici Am ith *[J 01 DB 05, J 01 DD 02, J 01 DD 14, J 01 DH 02, J 01 EA 01, J 01 EE 01, J 01 MA 02 and J 01 MA 14] Figure B, In focus, A national IT tool for surveilliance vo cin xa flo ici n nt am Ge [J 0 r* he Ot 3] ] ] 2] A 1 B 0 1 G 01 FF 1 M [J 0 01 [J 01 FA 1] D 0 1 D 5] R 0 1 C 01 [J [J 0 in yc am in d Kl in yc xi m ro m Er yt ta fo 2] 2] R 0 1 C r[ J 0 F 0 1 C ] 2] E 0 1 C [J 0 ] ] E 0 1 1 C [J 0 04 CA 01 [J ] CA 01 01 [J 02 AA 01 [J r[ J 0 bi to hi in Ce e m Le zy en e m lin cil V G) illi n xa Cl o ni v Pe llin ici en ici llin ox Am (p en zy llin ni ci ith w w ns yl pe Be cil lin pi Am cli n cy xy Do Number of ordinations 200 180 160 140 120 100 80 60 40 20 0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 J 01 excl methenamine 1. 18 1. 22 1. 25 1. 33 1. 36 1. 43 1. 49 1. 55 1. 52 1. 48 1. 52 1. 59 1. 63 1. 60 Methenamine (J 01 XX 05) 0. 03 0. 02 0. 05 0. 07 0. 05 0. 03 0. 02 Total J 01 1. 25 1. 27 1. 37 1. 43 1. 50 1. 56 1. 62 1. 57 1. 52 1. 55 1. 61 1. 65 1. 62 Källa: Folkhälsomyndigheten 2015 Table 1. 6. Sid 38. 2021 -09 -08

0, 3 3 rd gen. cephalosporins (J 01 DD) 2 nd gen. cephalosporins (J 01 DC) 1 st gen. cephalosporins (J 01 DB) DDD/1000 inhabitants and day 0, 25 0, 2 0, 15 0, 1 0, 05 0 2000 Figure 1. 27. Sid 39. 2021 -09 -08 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Total number of adverse Number of ’serious’ drug reaction reports Ciprofloxacin 202 114 Flucloxacillin 180 115 Phenoxymethylpenicillin 158 70 Sulfamethoxazole and trimethoprim 130 80 Clindamycin 121 70 Nitrofurantoin 120 73 Amoxicillin 99 43 Doxycycline 92 43 Cefotaxime 88 41 Piperacillin and enzyme inhibitor 82 43 Number of fatal cases 2 7 0 1 2 2 0 0 1 0 Källa: Folkhälsomyndigheten 2015 Table 1. 7. Sid 40. 2021 -09 -08

2010 2011 2012 2013 2014 2010 2014 28 25 19 28 46 146 3 3 4 10 12 32 tendinitis 3 2 3 3 1 12 tendon rupture 2 3 3 3 1 12 Skin- and subcutaneous tissue 11 5 4 5 13 38 Psychiatric disorders 5 4 0 7 7 23 24 25 30 20 21 120 6 4 16 8 7 41 dyspnoea 3 1 4 5 4 17 interstitial pneumonia 2 0 2 1 0 5 pulmonary fibrosis 0 0 3 6 10 10 17 6 4 47 7 6 3 10 2 28 3 3 2 4 1 13 Fluoroquinolones (J 01 MA) Total no of reports Number of reactions Musculoskeletal Nitrofurantoin (J 01 XE 01) Total no of reports Number of reactions Respiratory system Skin- and subcutaneous tissue General disorders fever Källa: Folkhälsomyndigheten 2015 Table 1. 8. Sid 41. 2021 -09 -08

0, 0100 2009 2010 2011 2012 2013 2014 DDD/1000 inhabitants and day 0, 0080 0, 0060 0, 0040 0, 0020 J 02 AA 01 amfotericin b Figure 1. 28. Sid 42. 2021 -09 -08 J 02 AC 03 vorikonazol J 02 AC 04 posakonazol J 02 AX 04 kaspofungin J 02 AX 05 mikafungin J 02 AX 06 anidulafungin

800 Number of positive blood cultures per 100 000 inhabitants 7000 Number of analyses per 100 000 inhabitants 6000 5000 4000 3000 2000 1000 0 600 500 400 300 200 100 0 2007 Blood cultures Screen MRB Figure 2. 1. number 1 Sid 43. 2021 -09 -08 700 2008 2009 2010 2011 General culture Positive blood cultures 2012 2013 2014

350 300 2500 250 200 1500 150 100 500 50 0 0 2007 2008 Staphylococcus aureus Streptococcus pneumoniae Figure 2. 1. number 2 Sid 44. 2021 -09 -08 2009 2010 2011 Escherichia coli Streptococcus pyogenes 2012 2013 2014 Number of positive streptococcus cultures per 100 000 inhabitants Number of positive S. aureus and E. coli cultures per 100 000 inhabitants 3500

12000 1600 10000 1400 1200 8000 1000 6000 800 600 400 200 0 0 2007 Nasopharynx Figure 2. 1. number 3 Sid 45. 2021 -09 -08 2009 Throat 2010 Urine 2011 2012 2013 2014 Number of urine analyses per 100 000 inhabitants Number of nasopharynx and throat analyses per 100 000 inhabitants 1800

140 800 120 700 100 600 80 500 400 60 300 40 20 100 0 0 2008 2009 Faeces- C. difficile (toxin) 2010 Toxinpositive Clostridium difficile Figure 2. 1. number 4 Sid 46. 2021 -09 -08 2011 2012 2013 2014 Number of toxinpositive C. difficile samples per 100 000 inhabitants Number of faeces analyses per 100 000 inhabitants 900

Species Number of cases Proportion, % Escherichia coli 8161 89. 2 Klebsiella pneumoniae 668 7. 3 Proteus mirabilis 72 0. 8 Citrobacter species 40 0. 4 Shigella species 23 0. 3 Salmonella species 16 0. 2 166* 1. 8 Enterobacreiaceae (not specified or species not reported) Total number reported 9146** * Distinction between an ESBL and a chromosomally mediated Amp. C was not made for these bacteria. **In 239 patients two or more ESBL-producing species were reported resulting in a higher number of isolates than number of cases reported. Källa: Folkhälsomyndigheten 2014 Table 2. 1. Sid 47. 2021 -09 -08

öp nk Kr in on g ob er S Vä toc g k st ra hol Gö m Vä tala nd st m an la nd S Sw kå ne ed en to ta Ka l lm a Up r ps al a Ha lla nd Gä vl eb or g Ör eb ro Vä rm la nd Bl ek in Jä ge m tl Vä st and er b Sö de otte rm n an la nd D Vä al ar st n er no a r rl Ös te and rg öt No land rr bo tte Go n tla nd Jö ESBL-cases per 100 000 inhabitants 160 140 120 100 80 60 40 20 0 County 2010 Sid 48. 2021 -09 -08 Figure 2. 2. 2011 2012 2013 2014

Number of cases per 100 000 inhabitants E. coli, women 350 300 250 200 150 100 50 0 0 -4 urine Figure 2. 3. number 1 Sid 49. 2021 -09 -08 5 -9 10 -1415 -1920 -2425 -2930 -3435 -3940 -4445 -4950 -5455 -5960 -6465 -6970 -7475 -7980 -84 >85 fecal/rectal blood wound other

E. coli, men 350 Number of cases per 100 000 inhabitants urine fecal/rectal blood wound other 300 250 200 150 100 50 0 0 -4 Figure 2. 3. number 2 Sid 50. 2021 -09 -08 5 -9 10 -14 15 -19 20 -24 25 -29 30 -34 35 -39 40 -44 45 -49 50 -54 55 -59 60 -64 65 -69 70 -74 75 -79 80 -84 >85

K. pneumoniae, women 50 Number of cases per 100 000 inhabitants urine fecal/rectal blood wound other 45 40 35 30 25 20 15 10 5 0 0 -4 Figure 2. 3. number 3 Sid 51. 2021 -09 -08 5 -9 10 -14 15 -19 20 -24 25 -29 30 -34 35 -39 40 -44 45 -49 50 -54 55 -59 60 -64 65 -69 70 -74 75 -79 80 -84 >85

K. pneumoniae, men Number of cases per 100 000 inhabitants 50 urine 45 fecal/rectal blood wound other 40 35 30 25 20 15 10 5 0 0 -4 Figure 2. 3. number 4 Sid 52. 2021 -09 -08 5 -9 10 -14 15 -19 20 -24 25 -29 30 -34 35 -39 40 -44 45 -49 50 -54 55 -59 60 -64 65 -69 70 -74 75 -79 80 -84 >85

50 45 Number of cases 40 35 30 25 20 15 10 5 0 2007 Domestic Figure 2. 4. Sid 53. 2021 -09 -08 2008 Imported 2009 2010 No data 2011 2012 2013 2014

Källa: Folkhälsomyndigheten 2015 Figure, In Focus – ESBL producing Escherichia coli Sid 54. 2021 -09 -08

Sid 55. 2021 -09 -08 Figure 2. 5. 2009 NDM OXA-48 2010 KPC VIM 2011 IMP 2012 K. K. K. 2013 e pp rs he Ot i ol on ia m eu pn e i p sp E. c he r Ot on ia ol E. c m eu pn e i pp rs he Ot on ia ol E. c m eu pn Number of cases 35 30 25 20 15 10 5 0 2014

NDM OXA-48 KPC VIM IMP 15 20 25 Unknown Africa Asia Europe Middle East North/South America Sweden 0 5 Number of cases Figure 2. 6. Sid 56. 2021 -09 -08 10 30 35 40

County Blekinge Dalarna Gotland Gävleborg Halland Jämtland Jönköping Kalmar Kronoberg Norrbotten Skåne Stockholm Södermanland Uppsala Värmland Västerbotten Västernorrland Västmanland Västra Götaland Örebro Östergötland Total 2010 No 8 27 5 26 40 28 54 72 23 21 313 412 30 41 28 39 30 32 264 40 47 1580 2011 Inc* 5. 2 9. 7 8. 7 9. 4 13. 4 22. 1 16. 0 30. 8 12. 5 8. 4 25. 2 20. 0 11. 1 12. 2 10. 2 15. 0 12. 4 12. 7 16. 7 14. 3 10. 9 16. 8 *=Incidence (cases per 100 000 inhabitants) Table 2. 4. Sid 57. 2021 -09 -08 No 17 38 9 36 51 19 61 45 40 20 369 502 34 42 48 20 24 28 347 44 71 1884 2012 Inc* 11. 1 13. 7 15. 7 13. 0 16. 9 15. 0 18. 1 19. 3 21. 7 8. 0 29. 5 24. 0 12. 5 12. 4 17. 6 8. 0 9. 9 11. 0 21. 8 15. 6 16. 5 19. 9 No 24 33 11 35 47 33 82 72 40 31 384 589 32 80 40 21 35 31 360 55 62 2097 2013 Inc* 15. 8 11. 9 19. 2 12. 7 15. 5 26. 1 24. 2 30. 8 21. 5 12. 5 30. 4 27. 7 11. 6 23. 4 14. 6 8. 1 14. 5 12. 1 22. 5 19. 4 14. 3 21. 9 No 32 35 15 51 58 54 126 82 54 39 394 623 50 76 80 34 40 50 439 50 72 2454 2014 Inc* 20. 9 12. 6 26. 2 18. 3 18. 9 42. 7 36. 9 35. 1 28. 9 15. 6 30. 9 28. 8 18. 0 22. 0 29. 2 13. 0 16. 5 19. 3 27. 2 17. 5 16. 4 25. 4 No 37 61 17 50 55 51 118 140 89 73 488 685 66 98 66 40 56 68 463 106 94 2921 Inc* 24. 0 21. 9 29. 7 17. 9 17. 7 40. 2 34. 3 59. 4 47. 1 29. 2 37. 9 31. 2 23. 5 28. 1 24. 0 15. 2 23. 0 26. 0 28. 4 36. 8 21. 3 30. 0 Källa: Folkhälsomyndigheten 2015

3500 3000 Number of cases 2500 2000 1500 1000 500 0 2010 Domestic Figure 2. 8. Sid 58. 2021 -09 -08 2011 Imported No data 2012 2013 2014

45 Cases per 100 000 inhabitants 40 35 30 25 20 15 10 5 0 2010 0 -6 Figure 2. 9. Sid 59. 2021 -09 -08 7 -19 2011 20 -59 60 -79 2012 80 - 2013 2014

160 Cases per 100 000 inhabitants 140 120 100 80 60 40 2010 0 y Figure 2. 10. Sid 60. 2021 -09 -08 1 y 2 y 2011 3 y 4 y 2012 5 y 6 y 2013 2014

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2010 2011 2012 2013 2014 (835) (973) (1078) (1266) (1452) Domestic Clinical symptoms Figure 2. 11. A Sid 61. 2021 -09 -08 Contact tracing Screening Other/missing

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2010 2011 2012 2013 2014 (834) (973) (1078) (1266) (1452) Domestic Community-acquired Figure 2. 12, A. Sid 62. 2021 -09 -08 Hospital-acquired Healthcare/Care outside hospital Other/missing

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2010 2011 2012 2013 2014 (731) (879) (998) (1157) (1428) Imported Community-acquired Figure 2. 12, B. Sid 63. 2021 -09 -08 Hospital-acquired Healthcare/Care outside hospital Other/missing

2010 spa-type 2011 spa-type 2012 spa-type t 008 t 002 t 008 t 044 t 019 2013 No. 2014 No. PVL-pos (%) spa-type 176 88 t 223 232 3 t 002 166 29 t 008 186 81 t 019 t 223 139 1 t 044 178 94 t 044 t 223 t 044 121 93 t 002 172 32 t 223 t 044 t 127 104 27 t 127 38 t 437 t 127 t 019 93 94 t 304 120 10 t 127 t 437 t 304 59 8 t 019 116 91 t 032 t 690 t 015 t 437 47 77 t 690 71 72 t 015 t 304 t 690 46 46 t 437 69 62 t 021 t 790 t 690 t 386 32 0 t 386 51 6 t 688 32 0 PVL-pos (%) Källa: Folkhälsomyndigheten 2015 Table 2. 5. Sid 64. 2021 -09 -08

Domestic Imported spa-type No. PVL-pos (%) t 223 109 5 t 223 118 2 t 002 106 32 t 008 86 80 t 008 100 82 t 044 79 90 t 044 96 97 t 019 71 90 t 304 64 8 t 127 65 43 t 127 59 34 t 002 64 31 t 019 44 95 t 304 52 10 t 690 38 87 t 437 36 61 t 267 32 0 t 386 32 6 t 790 32 0 t 690 30 50 Källa: Folkhälsomyndigheten 2015 Table 2. 6. Sid 65. 2021 -09 -08

700 Number of cases 600 500 400 300 200 100 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 (24) (53) (617) (402) (214) (122) (152) (227) (402) Domestic Figure 2. 14. Sid 66. 2021 -09 -08 Imported No data

Species and R-gene E. faecium van. A E. faecium van. B E. faecalis van. A 2006 2007 2008 2009 2010 2011 2012 2013 2014 9 12 96 61 63 39 97 93 110** 3 38 505 326 135 70 26 126 281**, *** 2 2 4 6 3 8 5 1 3 1 2 E. faecalis van. B Not specified Total 5*** 10 1 12 9 12 3 24 7 6 24 53 617 402 214 122 152 227* 402 *In one case in 2013 a strain of E. faecium with both van. A and van. B gene was detected. **In two cases in 2014 a strain of E. faecium with both van. A and van. B gene was detected. ***In one case in 2014 both E. faecium van. B and E. faecalis van. B could be isolated. Källa: Folkhälsomyndigheten 2015 Table 2. 9. Sid 67. 2021 -09 -08

Salmonella serovar No of isolates tested for Cip No of Cip-R No of isolates tested for Tsu No of Tsu-R S. Typhi 14 13 9 14 2 India (3), Nepal (1), Thailand (1), Zambia (1) S. Enteritidis 8 8 3 8 S. Panama 3 3 Thailand S. Serogroup C 3 2 3 S. Serogroup D 3 2 S. Typhimurium 3 2 3 S. Heidelberg 2 2 2 S. Stanley S. other serovars 2 23 2 20 2 5 Total 61 54 20 1 3 Countries reported (no) Ghana 1 Unspecified travel 2 22 6 Africa (1), Bali (1), India (1), Kenya (1), Marocko (1), Sri Lanka (1), Thailand (3), Turkey (1) 60 12 Källa: Folkhälsomyndigheten Table 3. 1. Sid 68. 2021 -09 -08

Escherichia coli Klebsiella pneumoniae Pseudomonas aeruginosa Staphylococcus aureus Streptococcus pneumoniae Enterococcus faecalis Enterococcus faecium 7000 6000 5000 4000 3000 2000 1000 0 2007 Figure 4. 1. Sid 69. 2021 -09 -08 2009 2010 2011 2012 2013 2014

Species Antibiotic Escherichia coli total no of isolates Ctx Imp/Mer Gen/Tob Fluoroquinolones Ptz** Klebsiella pneumoniae total no of isolates Ctx Imp/Mer Gen/Tob Fluoroquinolones Ptz** Pseudomonas aeruginosa total no of isolates Caz Imp/Mer Gen/Tob Fluoroquinolones Ptz** Staphylococcus aureus total no of isolates Oxa/Fox Van Streptococcus pneumoniae total no of isolates Pen (I+R) Ery Enterococcus faecalis total no of isolates Van Gen (HLAR) Enterococcus faecium total no of isolates Van Gen (HLAR) Acinetobacter species*** total no of isolates Imp/Mer 2007 2008 2009 2010 2011 n %R n %R 3745 4028 4423 4991 5066 2. 3 2. 9 3. 2 4. 0 0. 0 2. 2 2. 3 3. 3 4. 5 5. 1 13. 3 14. 4 13. 7 14. 0 10. 4 nd nd nd 649 826 755 908 934 1. 4 2. 3 1. 8 2. 3 2. 2 0. 0 0. 0 1. 1 1. 0 2. 1 10. 8 12. 9 12. 2 8. 5 5. 0 nd nd nd 335 309 326 337 402 4. 5 5. 2 6. 9 5. 2 7. 1 4. 0 7. 7 6. 7 7. 2 0 0 0 3. 0 10. 4 7. 6 10. 1 7. 0 nd nd nd 2163 2409 2457 2856 3143 0. 5 0. 7 1. 0 0. 5 0. 8 0. 0 0. 0 2012 n %R 5336 4. 4 0. 0 5. 5 9. 9 nd 933 2. 6 0. 0 2. 1 4. 6 nd 350 6. 9 1. 4 9. 1 nd 3268 0. 7 0. 0 2013 2014 n %R n n tested % R* 6323 6586 4. 9 6576 5. 4 0. 0 6321 0. 0 4. 5 6577 6. 3 9. 9 5170 11. 7 nd 6285 2. 3 1028 1009 3. 1 951 4. 0 0. 0 984 0. 2 2. 0 1008 3. 2 4. 4 766 5. 1 nd 964 9. 3 428 432 6. 5 437 5. 5 6. 3 432 7. 6 2. 3 445 1. 8 7. 9 345 7. 5 nd 442 5. 0 3209 3519 1. 2 3511 0. 9 0. 0 1026 0. 0 1028 992 861 1213 3. 0 5. 2 651 1060 2. 0 5. 2 720 0. 0 16. 1 279 960 3. 3 3. 9 718 0. 0 20. 1 333 1019 3. 8 3. 9 776 0. 0 18. 6 311 3. 5 4. 5 824 0. 0 15. 2 339 5. 0 5. 1 779 0. 0 16. 6 406 797 6. 6 5. 8 851 0. 0 14. 1 391 797 793 6. 2 894 673 0. 0 15. 6 456 351 0. 7 22. 5 59 3. 4 912 0. 0 13. 3 431 457 0. 0 14. 4 1. 5 24. 8 0. 5 24. 1 0. 3 21. 8 0. 0 22. 0 0. 0 18. 4 1. 4 20. 4 nd nd 59 *From 2014 the resistance is expressed as % of isolates tested **Ptz was included from 2014 ***Acinetobacter species was included from 2014 Table 4. 1. Sid 70. 2021 -09 -08 Källa: Folkhälsomyndigheten 2015

E. coli, Cefotaxime K. pneumoniae, Cefotaxime P. aeruginosa, Ceftazidime 10 8 6 4 2 0 2007 Figure 4. 2. Sid 71. 2021 -09 -08 2009 2010 2011 2012 2013 2014

Antibiotic 2008 (n=11. 115) * Species Streptococcus pyogenes: n (% of total) 0. 5 Tet 2. 2 14. 6 107 (1. 0) Ery 2011 (n=16. 969) 2012 (n=18. 117) 2013 (n=18. 367) 2014 (n=12. 609) 7. 7 205 (1. 1) 13. 2 5. 8 76 (0. 5) 4. 0 12. 5 197 (1. 1) 6. 8 5. 4 75 (0. 6) 2. 3 13. 3 206 (1. 2) 7. 8 3. 8 49 (0. 4) 3. 2 12. 7 166 (1. 4) 6. 9 6. 5 63 (0. 6) 1. 7 9. 7 131 (1. 1) 6. 5 Kli Haemophilus influenzae: n (% of total) 2010 (n=12. 296) n (% of n (% of n % tot) tot) tested R** %R %R %R 196 (1. 8) 134 (1. 2) 118 (1. 0) 188 (1. 1) 257 (1. 4) 297 (1. 6) 149 (1. 2) Ery Streptococcus agalactiae: n (% of total) 2009 (n=11. 416) 2. 0 141 7. 8 184 13. 6 158 10. 1 184 (1. 5) 12. 7 13. 7 103 (0. 6) 149 9. 3 87 (0. 5) 70 (0. 6) Amp 25. 4 20. 4 9. 3 18. 4 20. 4 25 61 14. 8 Ctx nd nd nd 2. 5 1. 9 0 58 0. 0 Tsu 14. 3 13. 3 15. 8 22. 3 17. 2 70 21. 4 * Total number of positive blood isolates from participating laboratories ** from 2014 the resistance is expressed as % resistance of isolates tested Table 4. 2. Sid 72. 2021 -09 -08 Källa: Folkhälsomyndigheten 2015

35 30 25 Ampicillin Mecillinam 20 Cefadroxil Nitrofurantoin 15 Nalidixic acid Ciprofloxacin 10 Trimethoprim 5 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Figure 4. 3. Sid 73. 2021 -09 -08

20 15 Cefadroxil Mecillinam 10 Nalidixic acid Ciprofloxacin 5 Trimethoprim 0 2005 Figure 4. 4. Sid 74. 2021 -09 -08 2006 2007 2008 2009 2010 2011 2012 2013 2014

20 15 Gentamicin Tobramycin Ceftazidime 10 Piperacillin-Tazo Imipenem 5 Meropenem Ciprofloxacin 0 2006 Figure 4. 5. Sid 75. 2021 -09 -08 2007 2008 2009 2010 2011 2012 2013 2014

10 9 Oxacillin/Cefoxitin 8 Erytromycin 7 6 Klindamycin 5 Fusidinsyra 4 Genta/Tobra 3 2 Norfloxacin 1 0 2002 2003 Figure 4. 6. Sid 76. 2021 -09 -08 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

12 11 10 9 Oxacillin (=Penicillin I+R) 8 7 Erytromycin 6 Klindamycin 5 Tetracyklin 4 3 Trimetoprim-sulfa 2 Norfloxacin 1 0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Figure 4. 7. Sid 77. 2021 -09 -08

35 30 Betalactamase production 25 Other betalactam resistance 20 Tetracycline 15 Trimethoprim-sulfonamide 10 Nalidixic acid 5 0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Figure 4. 8. Sid 78. 2021 -09 -08

Antimicrobial Type % R 2014 (2013) Distribution (n) of MICs (mg/L) <0. 008 Clindamycin Erythromycin Moxifloxacin 0. 016 0. 03 0. 06 0. 12 0. 25 0. 5 1 2 012 89 (75) 017 100 (79) 027 50 (-) 2 046 0 (53) 1 231 100 (100) 4 8 16 32 64 128 256 1 1 16 8 1 2 6 Other 13 (7) 1 2 26 45 94 99 32 27 15 4 24 Total 18 (15) 1 2 26 47 97 100 35 28 17 5 54 012 94 (75) 1 14 107 100 (79) 027 67 (-) 2 046 0 (46) 1 231 100 (100) 1 2 8 6 2 1 5 Other 13 (9) 4 40 131 116 37 3 1 4 33 Total 19 (16) 4 40 131 120 39 5 1 6 66 012 55 (63) 017 75 (59) 1 027 83 (40) 1 046 0 (27) 2 231 100 (100) 3 5 10 1 6 5 1 6 Other 9 (6) 7 70 193 66 5 30 Total 14 (14) 7 73 202 68 5 57 Källa: Folkhälsomyndigheten 2014 Table 4. 3. Sid 79. 2021 -09 -08

Figure 4. 9. Sid 80. 2021 -09 -08 Källa: Folkhälsomyndigheten 2015

2007 (n=406) 2008 (n=447) 2009 (n=384) 2010 (n=618) 2011 (n=805) 2012 (n=877) 2013 (n=967) 2014 (n=384) β-lactamase positive 30 28 44 29 23 23 18 28 Ampicillin 30 28 44 31 24 23 18 28 Cefixime <1 1 5 6 8 10 4 2 Ceftriaxone 0 <1 0 2 2 1 <1 (0. 3) Azithromycin 7 13 6 12 11 10 13 9 Ciprofloxacin 70 63 75 56 55 62 53 60 Spectinomycin 0 0 0 0 Källa: Folkhälsomyndigheten 2015 Table 4. 4. Sid 81. 2021 -09 -08

Year of diagnosis 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 448 395 361 434 510 523 473 498 522 Culture confirmed M. tuberculosis No % No % No % Any resistance 52 11. 6 43 10. 9 49 13. 6 57 13. 1 58 11. 4 68 13 73 15. 4 60 12 58 10. 7 65 12. 4 Isonazid 46 10. 3 38 9. 6 46 12. 7 51 11. 8 51 10 57 10. 9 57 12 49 9. 8 44 8. 4 51 9. 8 Rifampicin 5 1. 1 6 1. 5 15 4. 2 15 3. 5 14 2. 7 20 3. 8 19 4 15 3 10 1. 9 18 3. 4 Ethambutol 3 0. 7 1 0. 3 7 1. 9 6 1. 4 7 1. 4 12 2. 3 10 2. 1 12 2. 4 8 1. 5 15 2. 9 Pyazinamid 6 1. 3 6 1. 5 11 3 18 4. 1 15 2. 9 20 3. 8 27 5. 7 23 4. 6 14 2. 7 23 4. 4 Isonazid+ rifampicin (MDR) 4 0. 9 3 0. 8 15 4. 2 14 3. 2 13 2. 5 18 3. 4 17 3. 6 14 2. 8 8 1. 5 15 2. 9 Källa: Folkhälsomyndigheten 2015 Table 4. 5. Sid 82. 2021 -09 -08

0 -6 years Stockholm 7 -19 years 20 -64 years 65 -79 years 80 years- All ages 202 618 314 385 1 309 052 251 770 85 217 2 163 042 Uppsala 28 966 49 684 205 011 46 544 15 276 345 481 Södermanland 22 363 41 534 153 272 44 984 15 416 277 569 Östergötland 35 599 63 294 251 874 63 345 23 736 437 848 Jönköping 28 352 51 707 191 540 49 641 19 995 341 235 Kronoberg 15 243 27 467 105 382 27 771 11 293 187 156 Kalmar 16 761 32 009 129 149 40 896 15 059 233 874 Gotland 4 017 7 710 32 129 9 937 3 368 57 161 Blekinge 11 457 21 535 84 353 25 957 9 455 152 757 110 088 180 090 739 599 178 187 66 105 1 274 069 25 314 46 487 170 867 47 124 17 048 306 840 135 824 229 918 943 911 222 346 83 085 1 615 084 Värmland 19 821 37 496 153 705 45 227 17 566 273 815 Örebro 23 426 41 291 161 296 43 803 15 579 285 395 Västmanland 20 507 37 425 145 942 40 530 14 650 259 054 Dalarna 20 662 39 148 153 213 47 050 17 276 277 349 Gävleborg 20 389 39 106 154 663 47 159 16 653 277 970 Västernorrland 17 974 34 286 133 889 41 151 14 856 242 156 9 590 17 603 70 767 20 718 7 783 126 461 Västerbotten 20 510 36 499 151 526 38 544 14 033 261 112 Norrbotten 17 337 34 236 141 789 41 806 14 268 249 436 806 818 1 382 910 5 582 929 1 374 490 497 717 9 644 864 Skåne Halland Västra Götaland Jämtland Sweden Källa: Folkhälsomyndigheten 2015 Table 7. 1. Sid 83. 2021 -09 -08

2001 Population 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 8 882 792 8 909 128 8 940 788 8 975 670 9 011 392 9 047 752 9 113 257 9 182 927 9 256 347 9 340 682 9 415 570 9 482 855 9 555 893 9 644 864 Källa: Folkhälsomyndigheten 201 5 Table 7. 2. Sid 84. 2021 -09 -08

Year Admissions Patient-days 2010 1 473 835 6 958 834 2011 1 496 324 6 979 857 2012 1 514 608 6 859 956 2013 1 385 962 6 144 504 Källa: Folkhälsomyndigheten 2015 Table 7. 3. Sid 85. 2021 -09 -08

County Admissions Patient-days Blekinge 23 906 119 436 Dalarna 46 829 197 578 Gotland 9 776 41 628 Gävleborg 37 348 161 958 Halland 42 884 186 426 Jämtland 18 719 87 576 Jönköping 56 083 240 222 Kalmar 42 855 160 023 Kronoberg 26 423 124 862 Norrbotten 38 793 184 320 Skåne 193 500 868 293 Stockholm 235 036 897 561 Södermanland 36 294 180 197 Uppsala 56 542 287 668 Värmland 40 654 191 352 Västerbotten 50 639 241 877 Västernorrland 37 843 171 817 Västmanland 38 094 176 128 241 812 1 131 076 Örebro 45 003 216 246 Östergötland 66 929 278 260 1 488 460 6 776 274 Västra Götaland Sweden Källa: Folkhälsomyndigheten 2015 Table 7. 4. Sid 86. 2021 -09 -08

2 363 3735* 4 632 6 260 571 459 11 502 3 487 10 253 11 606 2 644 9 390 30 717 4 776 22 842 9 325 2 968 1 415 7 751 8 955 NA 3 655 3 837 3 326 5 148 935 4 293 5 795 2 539 164 805 3 419 NA 2 107 1 906 1 843 3 581 488 2 230 2 936 1 294 74 261 1 278 NA 2 121 2 394 1 599 2 366 460 2 149 2 019 953 67 733 6 196 NA 3 824 4 999 4 990 6 519 1 560 4 171 7 049 3 216 172 898 9 280 5 085 857 443 712 952 597 100 009 2 900 1 358 969 3 447 2 211 2 960 1 667 7 11 12 19 8 17 8 2 4 25 39 8 23 4 28 31 24 66 26 39 28 193 262 6 339 3 638 2 054 2 358 11 210 13 422 8 376 8 054 35 000 36 751 6 067 4 096 3 642 2 024 88 553 24 696 71 033 2 801 959 1 912 30 932 7 194 17 841 9 075 2 771 11 222 79 760 23 505 30 969 264 327 9 707 49 947 158 701 46 676 161 792 21 354 5 462 25 717 14 064 137 3 967 2 629 14 721 11 009 55 829 12 115 NA 14 194 20 320 16 079 21 196 4 669 14 164 17 530 7 612 524 959 88 NA 152 234 531 957 36 165 251 110 11 629 7 121 NA 2 129 1 936 3 673 7 187 2 109 2 713 10 437 2 512 152 841 2 200 NA 1 291 1 450 1 795 2 616 382 1 646 1 677 1 158 65 907 12 243 NA 6 704 9 089 8 217 16 662 3 013 9 883 15 380 6 879 363 958 52 109 NA 5 749 17 518 7 478 15 143 NP 4 135 8 695 4 734 597 648 46 630 NA 27 328 32 439 30 847 35 915 6 764 28 771 33 882 18 379 1 068 597 5 4 2 1 2 6 4 *not pair; NP, not performed; NA, data not available Table 7. 5. Sid 87. 2021 -09 -08 441 377 615 581 239 100 502 469 896 249 446 542 300 444 971 001 328 251 596 500 756 4 3 3 10 6 7 4 790 932 119 561 038 050 446 Faeces 43 496 23 994 875 019 282 540 056 920 651 303 856 978 550 030 070 811 4 5 5 11 4 8 4 (toxinpositive) 692 567 360 1 136 586 501 434 19 054 3 267 Clostridium difficile 768 542 427 583 520 500 553 10 626 6 820 Escherichia coli S: t Göran (Unilabs) Sunderby Luleå Sundsvall NÄL Trollhättan Umeå Uppsala Visby Västerås Örebro Östersund Total 607 491 072 144 670 020 950 4 212 1 859 Streptococcus pyogenes Skövde (Unilabs) 2 1 1 5 2 3 1 Streptococcus pneumoniae 19 500 19139* 1 2 2 4 2 2 1 Staphylococcus aureus Karlskrona/ Växjö Karlstad Karolinska Stockholm Linköping Lund/Malmö Blood (pair of bottles) 148 213 248 1 525 136 236 146 Clostridium difficile (toxin) 611 028 736 979 570 301 663 364 10 520 4 923 Laboratory Number of positive cultures 2014 4 645 4 797 Faeces SSYC 13 19 13 43 13 22 13 122 2 521 Urine Eskilstuna (Unilabs) Falun Gävle Göteborg Halmstad Jönköping Kalmar 1 336 1 902 Screen MRB 0 189 General culture 965 19 605 Throat Cerebrospinal fluid (CFS) Aleris Medilab Borås Number of positive samples 2014 Nasopharynx Blood (pair of bottles) Number of analyses 2014 876 479 10 490 7 220 272 145 7 9 8 16 8 11 9 654 075 629 126 600 790 605 271 279 386 468 323 460 267 586 627 10 300 9 931 482 244 2 646 427 2 204 3 026 699 2 751 42 474 9 060 44 779 1 323 333 1 223 282 703 13 715 333 658 865 NA NA 406 389 258 469 508 630 662 599 208 144 320 347 1 137 693 333 NP 15 999 18 159 11 876 NA 8 562 9 020 9 769 9 410 2 171 9 436 8 727 5 994 294 413 494 NA 327 255 385 562 36 367 380 242 9 857 Källa: Folkhälsomyndigheten 2015

J 01 AA 02 – doxycycline J 01 AA 04 – lymecycline J 01 AA 06 - oxitetracycline J 01 AA 07 - tetracycline J 01 AA 12 - tigecycline J 01 BA 01 - chloramphenicol J 01 CA 01 - ampicillin J 01 CA 04 - amoxicillin J 01 CA 08 - pivmecillinam J 01 CE 01 - benzylpenicillin J 01 CE 02 - fenoximethylpenicillin J 01 CF 02 - cloxacillin J 01 CF 05 - flucloxacillin J 01 CR 02 - amoxicillin and enzyme inhibitor-oral J 01 CR 05 - piperacillin and enzyme inhibitor J 01 DB 01 - cefalexin J 01 DB 03 - cefalotin J 01 DB 05 - cefadroxil J 01 DC 02 - cefuroxime- parenteral J 01 DC 02 - cefuroxime - oral J 01 DC 08 - loracarbef J 01 DD 01 - cefotaxime J 01 DD 02 - ceftazidime J 01 DD 04 - ceftriaxon J 01 DD 08 - cefixime J 01 DD 14 - ceftibuten J 01 DE 01 - cefepime J 01 DF 01 - aztreonam - parenteral J 01 DF 01 - aztreonam - inhalation J 01 DH 02 - meropenem J 01 DH 03 - ertapenem J 01 DH 51 - imipenem and enzyme inhibitor DDD (g) 0. 1 0. 6 1 1 0. 1 3 2 1 0. 6 3. 6 2 2 2 1 14 2 3 0. 5 0. 6 4 4 2 0. 4 2 4 0. 225 2 1 2 J 01 EA 01 - trimethoprim J 01 EC 02 - sulfadiazin J 01 EE 01 - sulfamethoxazol and trimethoprim J 01 FA 01 - erythromycin J 01 FA 01 - erythromycin erythylsuccinat tablets J 01 FA 06 - roxithromycin J 01 FA 09 - clarithromycin - oral J 01 FA 10 - azithromycin - parenteral J 01 FA 10 - azithromycin - oral J 01 FA 15 - telithromycin J 01 FF 01 - clindamycin - parenteral J 01 FF 01 - clindamycin - oral J 01 GB 01 - tobramycin - parenteral J 01 GB 01 - tobramycin - oral inhalation solution J 01 GB 01 - tobramycin - oral inhalation powder J 01 GB 03 - gentamicin J 01 GB 06 - amikacin J 01 GB 07 - netilmicin J 01 MA 01 - ofloxacin J 01 MA 02 - ciprofloxacin - parenteral J 01 MA 02 - ciprofloxacin - oral J 01 MA 06 - norfloxacin J 01 MA 12 - levofloxacin J 01 MA 14 - moxifloxacin J 01 XA 01 - vancomycin J 01 XA 02 - teicoplanin J 01 XB 01 - colistin J 01 XC 01 - fusidic acid J 01 XD 01 - metronidazole J 01 XE 01 - nitrofurantoin J 01 XX 04 - spectinomycin DDD (g) 0. 4 0. 6 1. 92 1 2 0. 3 0. 5 0. 3 0. 8 1. 2 0. 24 0. 3 0. 112 0. 24 1 0. 35 0. 4 0. 5 1 0. 8 0. 5 0. 4 2 0. 4 3 MU 1. 5 0. 2 3 Källa: Folkhälsomyndigheten 2015 Table Sid 88. 2021 -09 -08