PubMed · 8327953
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S Palsbo. 1993-02-03. [Executive Board].. https://pubmed.ncbi.nlm.nih.gov/8327953/
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BACKGROUNDIncreasing incidence rates of invasive Streptococcus dysgalactiae subspecies equisimilis (iSDSE) have been detected worldwide.AIMWe aimed to investigate iSDSE infection incidence rates in Denmark during 2014-2024, and characterise the genomic population structure of a subset of iSDSE isolates and their antimicrobial resistance (AMR).METHODSUsing national register data, we estimated overall and sex-/age-stratified iSDSE incidences during 2014-2024, by retrospectively identifying cases of invasive infections with group C and G streptococci or S. dysgalactiae (including specified as subspecies equisimilis). From the voluntary national beta-haemolytic streptococci laboratory surveillance system, whole-genome-sequenced isolates from August 2020-September 2022 were used to investigate the iSDSE genomic population structure. Susceptibility to penicillin, erythromycin and clindamycin was determined and AMR genes identified.RESULTSDuring 2014-2024, iSDSE incidence rates increased significantly (linear trend analysis p < 0.001) with mean annual incidence ranging between 10.3 and 16.4 per 100,000, peaking in 2023. Incidence was higher in males, increasing with older age. Nearly 75% of the 1,223 iSDSE isolates belonged to four of 14 genetic clusters. Sequence types (STs) ST20 and ST17 were most prevalent, while emm-type stG62647, a variant associated internationally with higher virulence, dominated. All isolates were phenotypically susceptible to penicillin but approximately 10% were respectively erythromycin and clindamycin resistant. High erythromycin resistance prevalence (57%; 39/68), coinciding with gene ermA, occurred in one genetic cluster.CONCLUSIONThe findings illustrate the need for national registry-based surveillance to detect epidemiological changes and potential outbreaks. Further, continuous genomic surveillance can monitor the occurrence and expansion of genetic clades and AMR genes.
Misuse of drugs in relation to doping has been known for many years in Denmark. The Sports Confederation of Denmark carries out about 1000 doping controls every year on athletes at both competitions and training-sessions. In the period 1991-1996, 5084 doping controls were performed. Six athletes who refused to participate were excluded from organized sport for a period of two years. Forty-three athletes were found positive for drugs; 32 were positive for androgenic-anabolic steroids, 11 were positive for different stimulants including amphetamine, cocaine, caffeine and ephedrine. The misuse of drugs outside organized sport is considered to be a growing problem. Three percent of all persons between fifteen and fifty years have tried some kind of doping. The number of misusers of androgenic-anabolic steroids in Denmark is considered to be around 10,000. Side-effects are numerous and include cardiovascular side-effects, psychiatric disturbances and hepatotoxicity. It is important that all doctors be aware of the side-effects and health problems in misusers.
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