DANMAP: monitoring antimicrobial resistance in Denmark.

The objectives of the Danish Integrated Antimicrobial Resistance Monitoring and Research Programme (DANMAP) are to monitor trends in resistance among bacteria from animals, food and humans, to monitor the consumption of antimicrobial agents and to determine the association between consumption and occurrence of resistance and to model transmission of resistance from animals to humans. DANMAP is based on the examination of representative bacterial isolates of animal and human pathogens, of zoonotic bacteria and of indicator bacteria. For food animals, both diseased and the healthy populations are studied. Isolates from all three reservoirs are examined for their susceptibility to a basic panel of antibiotics that includes representatives of the major classes of compounds, making comparison of resistance levels in the reservoirs possible. Isolates are stored in a strain collection and are available for further study. The data are stored in databases as MIC values or mm inhibition zones with all identifiers. A system for recording all use of the veterinary medicines, VETSTAT, is currently under implementation. For production animals, the consumption will be recorded for each herd, providing a basis for detailed modelling of the effect of consumption on resistance.