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PubMed2006

Patterns of antibiotic use in the community in Denmark.

A cross-sectional descriptive population survey was conducted in 2003 to examine epidemiological characteristics of antibiotic use in the community in Denmark and particularly in the area of self-medication with antibiotics. Self-medication with antibiotics was rare in Denmark. 97% of antibiotics used were obtained after a medical consultation. While the existing legal framework preventing over-the-counter dispensation of antibiotics must be maintained, our results show that, in Denmark, interventions to optimize antibiotic use should primarily focus on the prescribers.

Adolescent↗

PubMed2004

Experience from the first ACT programme in Denmark. I. Baseline evaluation 1981-2000.

In 1999, a Danish expert report strongly recommended the Assertive Community Treatment (ACT) model to be implemented in Denmark. On 1 May 2001 we started in the Tønder region (45,000 inhabitants), Sønderjylland (SJ) county (254,000 inhabitants), aiming an evaluation of the ACT model. Before starting the clinical study, an epidemiological baseline evaluation of trends in psychiatric service was performed. Data included all admissions to mental hospitals/wards from 1981 to 2000 from the intervention/control region (Tønder/Aabenraa) and from all Denmark together with outpatient data from the period 1995-2000. The bed rate in the SJ county (76/100,000 31 December 2000) was halved during the period. The staff increased by more than 50%. The increase in admission rate and decrease in bed days per admission showed homogeneous pattern between intervention and control region. The hospital incidence of schizophrenia and the first-time admission rate were at the same level in the intervention/control region and all Denmark, but the country had a higher use of beds. The point prevalence and referral rates of outpatients increased to around 6/1000 and 7/1000/year, respectively in both regions. In conclusion, the regions of intervention and control had, prior to the start of ACT, the same pattern of use of psychiatric services, enabling an unbiased register-based evaluation of effects.

Adult↗

PubMed2004

Is alcoholism a self-induced disease? A survey among doctors in Aarhus, Denmark and in Mainz, Germany.

The intent of this study was to explore differences in views concerning the statements "alcoholism is a disease" and "alcoholism is a self-induced disease" among doctors in two cities from two contrasting countries, relating to different official definitions of alcoholism, namely Denmark, where alcoholism is related to ways of lifestyle and Germany, where alcoholism is related to preliminary diseases. The data come from a postal anonymous survey, carried out between January and February 2000 in Aarhus and Mainz, sent to general practitioners and hospital doctors from surgery, internal medicine and psychiatry. The identified sample was n = 572, and the response rate = 66% (n = 374). As opposed to doctors in Aarhus (73.7%), significantly more doctors in Mainz (92.4%) described alcoholism as a disease, but independent of nationality, about half of the samples (no gender, age and healthcare settings differences) also agreed that "alcoholism is a self-induced disease". The governmental position on alcoholism seems to have an influence on doctors' evaluation: in Denmark, where alcoholism is defined as a disease of lifestyle, doctors in Aarhus were less likely to describe alcoholism as a disease than in Mainz, where alcoholism is seen as a preliminary disease. The ideological background for these differences is connected to the different influence of the temperance groups on the alcohol field -- less in Denmark and more in Germany. However, half of the doctors in Aarhus and Mainz viewed alcoholism as a self-induced disease and so indirectly assumed that alcoholics are responsible for their self-afflicted disease.

Alcoholism↗

PubMed2006

Pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Ten years experience in Denmark.

OBJECTIVES: To evaluate survival and functional outcome in patients treated by pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension in Denmark. DESIGN: Follow-up of the first 50 patients operated at Aarhus University Hospital, Denmark. RESULTS: Fifty patients underwent PEA in the period from 1994 to mid 2004. Prior to surgery all patients were in World Health Organization (WHO) function class III (n=33) or IV (n=17). The mean pulmonary artery pressure was 50 mmHg (range 25-76), cardiac index 1.8 l min(-1)m(-2) (range 0.8-2.8) and pulmonary vascular resistance 819 dyn s cm(-5) (range 241-3,067). In-hospital mortality was 12/50 (24%). Surgical mortality was highest in the early period. Since year 2000 in-hospital deaths occurred in only 2 among 23 patients (9%). Leading causes of death were persistent pulmonary hypertension and bleeding. Three patients died during long-term follow-up with a median observation time of 3 years. The overall 5 year survival rate was 74%. At 3 months follow-up 90% of the patients (34/38) had improved one or more WHO functional classes and the systolic pulmonary artery pressure estimated by Doppler echocardiography had decreased from 80 mmHg (range 49-115) to 43 mmHg (range 14-95). CONCLUSION: Pulmonary endarterectomy has been successfully implemented in Denmark. The perioperative mortality was reduced over time to 9% during the past 5 years. Functional outcome and long-term survival were excellent stressing the importance of surgical treatment for chronic thromboembolic pulmonary hypertension.

Adult↗

PubMed2006

HIV/AIDS knowledge and condom use among Somali and Sudanese immigrants in Denmark.

AIMS: This study explores the knowledge, attitudes and practices among Somali and Sudanese immigrants in Denmark with regard to HIV/AIDS and condom use. MATERIAL AND METHODS: A 78-item questionnaire, divided into five thematic sections, was given to 192 purposively selected Sudanese and Somalis of both sexes, aged 18-49, who had lived in Denmark for one or more years. It was administered in Arabic and Somali in four locations and supplemented by 13 semi-structured interviews. RESULTS: Education, sex, and nationality, but not length of residence in Denmark, were positively associated with knowledge about HIV/AIDS. Less than half of both men and women scored more than 70% on the knowledge portion of the questionnaire, while Sudanese knew more than Somalis. Men had a more negative attitude towards condoms than women, but greater knowledge about them. One-third of the women reported never having seen or heard of a condom, and almost half had never received information about condoms. Both sexes preferred receiving such information from the TV or friends instead of family doctors or HIV-positive individuals. CONCLUSIONS: This study suggests that knowledge about HIV/AIDS is low in these two Danish immigrant groups, both of which are characterized by reported incidence rates that are higher than the national average. The groups receive little information, while condom knowledge is particularly low among poorly educated women, and men have a negative attitude to condom use. The findings indicate a need for targeted, culturally sensitive HIV/AIDS information and advice.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Distribution of Puumala hantavirus in Denmark: analysis of bank voles (Clethrionomys glareolus) from Fyn and Jutland.

The majority of hantaviral infections in Denmark since 1957 have occurred on the island of Fyn. We have recently shown the presence of Puumala hantavirus (PUUV) in bank voles (Clethrionomys glareolus) on Fyn. To learn more about the distribution and prevalence of PUUV in Denmark, 310 small mammals, belonging to six rodent and two insectivore species, were trapped in four localities on Fyn and three localities on the Jutland Peninsula (mainland Denmark), where only a few cases of nephropathia epidemica (NE) have been confirmed so far. Serum samples (heart extracts) from all animals were initially analyzed for the presence of hantavirus-specific antibodies (Ab) by enzyme immunoassay, and lung tissue samples of bank voles for the presence of the viral nucleocapsid protein antigen by immunoblotting. Altogether 11 Ab-positive rodents were found, all of them bank voles from Fyn. PUUV genome sequences (nucleotides 2,168-2,569 from the medium genomic segment) were recovered by reverse transcription-polymerase chain reaction from seven bank voles. They showed an overall diversity up to 5% and formed a well-supported genetic lineage on the phylogenetic tree with a clustering of two strains from southeastern Fyn together and a separation from the one strain from western Fyn. Our data confirmed the circulation of PUUV in both the southeastern and western parts of the island, known to have the highest numbers of human NE cases.

Animals↗

PubMed1992

The disappearance of multiresistant Staphylococcus aureus in Denmark: changes in strains of the 83A complex between 1969 and 1989.

During the 1960s multiresistant strains of Staphylococcus aureus were problematic in Denmark and other countries. An analysis of the phage types and antibiotic resistance patterns of S. aureus strains collected from approximately 20,000 Danish patients per year has given us a general picture of the evolution of S. aureus in Denmark during the last 30 years. Multiresistant S. aureus (i.e., strains resistant to penicillin, streptomycin, and tetracycline and often to methicillin and erythromycin as well) belonged mostly to the 83A complex, a relatively homogeneous subset of group III strains that can be further divided into six subtypes. The disappearance of multiresistant strains in Denmark began with a decline in the frequency of isolation of the most resistant subtypes, which was followed by a gradual decrease in the resistance of all 83A subtypes; thus strains of the 83A complex ultimately became no more resistant than other strains. As the proportion of strains of S. aureus accounted for by the 83A complex declined from 24% in 1969 to 6% by the late 1980s, this complex was replaced by strains of type 95, the 94,96 complex, and group II, all of which only rarely show resistance to multiple agents.

Anti-Bacterial Agents↗

PubMed2003

Legal access to needles and syringes/needle exchange programmes versus HIV counselling and testing to prevent transmission of HIV among intravenous drug users: a comparative study of Denmark, Norway and Sweden.

BACKGROUND: Countries have adopted different strategies to prevent the transmission of HIV among intravenous drug users. Legal access to needles and syringes/needle exchange programmes as part of such a strategy has been heavily debated. HIV counselling and testing has also been part of prevention strategies. The objective of this study was to discuss the effectiveness of legal access to needles and syringes/ needle exchange programmes versus HIV counselling and testing among intravenous drug users (IDUs) as part of HIV prevention strategies. METHODS: Differences in HIV prevention strategies in Denmark, Norway and Sweden among IDUs are described. Outcome variables of effectiveness were HIV incidence rates over time. These were estimated by back calculation methods from 1980 through 1996, using data from the national HIV and AIDS registers. RESULTS: A comparison of HIV prevention strategies in Denmark, Norway and Sweden suggests that a high level of HIV counselling and testing might be more effective than legal access to needles and syringes/needle exchange programmes. Sweden and Norway, with higher levels of HIV counselling and testing, have had significantly lower incidence rates of HIV among IDUs than Denmark where there was legal access to needles and syringes and a lower level of HIV counselling and testing. In Sweden there was no legal access to drug injection equipment. CONCLUSION: Promotion and accessibility of HIV counselling and testing among intravenous drug users should be considered in countries where such a strategy is not adopted or has low priority.

AIDS Serodiagnosis↗

PubMed2005

Seeking asylum in Denmark: refugee children's mental health and exposure to violence.

AIMS: The aim of this study was to compare profiles of present mental health and previous exposure to violence among refugee children from the Middle East, whose asylum seeking families either did or did not obtain permission to stay in Denmark. METHODS: Shortly after arrival in Denmark, the parents of 311 Middle-Eastern children answered a structured interview on their children's exposure to organized violence and their mental health. The families were followed-up as concerns receipt of a residence permit. RESULTS: At arrival in Denmark, the children's patterns of previous exposure to violence and present mental health was generally similar irrespective of the family getting a residence permit, as was the case for 90 families (60.4%) with 190 children (61.1%). In both groups an overwhelming majority, eight to nine out of 10 children, had been exposed to conditions of war and had stayed in a refugee camp, and seven out of 10 had witnessed violence. Half of the children had a tortured parent. Considerably more children of families who did not get a residence permit had lost a parent (30.6% versus 13.7%; P<0.001). In both groups about two-thirds suffered from anxiety and about 30% from sleep problems, and children whose families did not later on get a residence permit more often appeared sad or miserable (43.8% versus 27.9%; P<0.005). CONCLUSIONS: The asylum-granting decision process seems to have divided the children into two groups with only superficial disparity as concerns their previous exposure to violence and their present mental health. There seems to be good reason to systematically integrate evidence on the children of refugee families in the treatment of applications for permission to stay.

Adolescent↗

PubMed2002

East-West gradient in semen quality in the Nordic-Baltic area: a study of men from the general population in Denmark, Norway, Estonia and Finland.

BACKGROUND: Denmark and Norway have a three-fold higher incidence of testicular cancer than Estonia and Finland. Groups of young men from Denmark, Norway, Finland and Estonia were investigated to elucidate whether semen parameters and other related parameters follow a gradient between these countries, as does the gradient in incidence of testicular cancer. METHODS: In total, 968 young men from the general population in these four countries were investigated according to the same protocol. Possible confounders were evaluated, and included in the statistical analysis when appropriate. Inter-laboratory differences in assessment of sperm concentrations were controlled by an external quality control programme and morphology assessment was centralized to one person. RESULTS: The Finnish and Estonian men had an adjusted median sperm concentration of 54 and 57 x 10(6)/ml, respectively and the Norwegian and Danish men 41 x 10(6)/ml. The corresponding total sperm counts were 185, 174, 133 and 144 x 10(6). The frequency of normal sperm in men from Finland was 8.9%, Estonia 9.2%, Norway 6.9% and Denmark 6.4%. Within all four groups of men, a relationship between increasing levels of inhibin-B and increasing sperm counts was observed. However, inhibin-B levels were not predictive of sperm count differences between countries. CONCLUSIONS: It is believed that the men examined were representative of the normal population of young men in all four countries as they were recruited from groups attending a compulsory medical examination, and not selected for known fertility or semen quality. Moreover, the majority of participants had no prior knowledge of their fertility potential. It appears that an east-west gradient exists in the Nordic-Baltic area with regard to semen parameters, this being in parallel with the incidences of testicular cancer. Further investigations are required to determine whether these findings are due to genetic differences, to different environments, or perhaps to a combination of both factors.

Adult↗

PubMed2002

Higher sperm counts in Southern Sweden compared with Denmark.

BACKGROUND: A common aetiology behind time-related deterioration of male reproductive function, including decline of sperm concentration and rising incidence of testicular cancer and cryptorchidism, has been suggested. Accordingly, a high incidence of testicular cancer and low sperm counts have been observed in Denmark, while in Finland opposite figures were found. This may be due to genetic factors. The incidence of testicular cancer is 50% lower in Sweden than in Denmark. Data on sperm counts in a population of Danish military conscripts have been published and we wished therefore to compare them with semen parameters in a corresponding cohort from Southern Sweden, geographically and genetically very closely related to Denmark. METHODS: A total of 305 military conscripts was recruited and investigated in an identical way as those in the Danish study including a questionnaire, physical examination and semen analysis. RESULTS: Men born and raised in Sweden had a 23% higher mean sperm concentration, a 31% higher mean total sperm count and a 14% higher seminal volume compared with their Danish counterparts. CONCLUSIONS: The differences in reproductive parameters between the two genetically very similar populations could not be explained by possible confounders and may be due to unknown environmental or lifestyle-related factors.

Adult↗

PubMed1983

Regional trends in incidence of cervical cancer in Denmark in relation to local smear-taking activity.

In this study the regional trends in the incidence of cervical cancer in Denmark from 1943 to 1977 are related to available data on the total smear-taking activity in the regions. In 1980 some 40% of women in Denmark were covered by organized screening programmes, but the total number of smears taken in the country was sufficient to cover the whole female population by an organized programme. Therefore, in order to evaluate the impact of the screening activity in Denmark account must be taken of trends in cervical cancer from areas both with and without organized programmes and of data for smears taken both in and outside the programmes. The study shows a considerable decline in the cumulative incidence of cervical cancer for women aged 30-59 in areas with organized screening programmes commenced before 1969. The decline in areas without organized programmes but with a higher or equivalent screening activity in 1974/75 is in general smaller or occurring later. In half of the areas with a lower level of smear-taking activity in 1974/75 only minor reductions in the incidence of cervical cancer are observed. Hysterectomies cannot explain the decline in the incidence for women below the age of 60. The observed pattern gives further evidence of a decline in the incidence of cervical cancer following the introduction of pap smears, but future trends should be kept under close surveillance.

Adult↗

PubMed1998

Secular trends in blood pressure levels in Denmark 1964-1991.

BACKGROUND: Hypertension is an essential risk factor for development of cardiovascular diseases. Prospective studies show a reduction in risk of myocardial infarction with reduction of blood pressure. In Denmark there was a decrease in ischaemic heart disease mortality during the period (1968-1992) with around 34% in 30-65 year old men and 30% in women. OBJECTIVE: To assess the changes in casual blood pressure between 1964 and 1991 in seven cross-sectional population studies. SETTING: Centre of Preventive Medicine, University of Copenhagen, DK-2600 Glostrup. POPULATION: 10359 subjects, equal numbers of men and women, age exactly 30, 40, 50 and 60 years drawn as random samples from a background population of 300000 inhabitants and surveyed in 1964-1974 and five cross-sectional studies 1976, 1978, 1982-1984, 1986-1987 and 1991. METHODS: Blood pressure was measured according to WHO criteria by one technician in each survey. Alcohol consumption and physical activity were measured by a self-administered questionnaire. The weight and height were measured by standardized methods. Data on mortality from ischaemic heart disease were obtained from death certificates recorded by the National Board of Health. RESULTS: Blood pressure increased with increasing age in both genders and was significantly higher in men than in women. Median blood pressure in 50 year old men in 1964 was 135/85 mmHg and in 1991 it was 123/79, whereas in women in 1964 it was 140/85, against 119/74 in 1991. The prevalence of hypertensives among 30 and 40 year olds declined throughout the period. The performance of blood pressure measurements, technical variation, examination programme, seasonal variation and inter-observer variation were potential bias sources and influenced blood pressure levels, but cannot be shown to be responsible for the declining trend in blood pressure and hypertension. Women became a little more physical active in leisure time and men less active. Women consumed less alcohol than men, but the amounts slightly increased by the end of the period. Body mass index >25 was seen less frequently in women than in men and this increased in men over the period. Sale of antihypertensive drugs increased in Denmark over the 1964-1991 period. There seems to be good agreement between the changes in blood pressure in the population and the decline in mortality from stroke and coronary heart disease in Denmark, which is influenced by other risk factors as well. CONCLUSION: Blood pressure distributions have shifted towards lower values in 1964-1991. Prevalence of hypertension declined up to 1983. Risk factor changes as well as treatment for hypertension contribute to this.

Adult↗

PubMed2003

Socioeconomic status and breast cancer in Denmark.

BACKGROUND: Breast cancer is the most frequent cancer in women and the incidence has increased over time. Our objectives were to study: (1) the socioeconomic differences in breast cancer incidence and mortality in Denmark, (2) how different socioeconomic groups have contributed to the increasing incidence, (3) whether the diverging trend between breast cancer incidence and mortality reflects different socioeconomic distributions of breast cancer cases and breast cancer deaths, and (4) to compare measures of socioeconomic status based on own and spouses' occupation, respectively. We addressed these questions by studying the socioeconomic distribution of breast cancer incidence and breast cancer mortality in Danish women during the last 25 years. METHODS: In all 1 402 225 women in Denmark were individually followed up for death, emigration, and incident breast cancer in 1970-1995. Of the 1 402 225 women included in the study, 730 549 were economically active in 1970, and 480 379 women were both married and economically active. Socioeconomic status was assessed based on the occupation in 1970. RESULTS: For all women classified by their own socioeconomic group, the standardized incidence (SIR) and the standardized mortality ratios (SMR) were highest in academics (SIR = 1.39, SMR = 1.29), and lowest in women in agriculture (SIR = 0.77, SMR = 0.75). For married, economically active women classified by their own socioeconomic group the SIR and SMR were highest in academics (SIR = 1.40, SMR = 1.44) and lowest in women in agriculture (SIR = 0.76, SMR = 0.76). Classified by their husbands' socioeconomic group, the SIR and SMR were highest in women married to academics (SIR = 1.21, SMR = 1.16) and lowest in women married to men in agriculture (SIR = 0.79, SMR = 0.79). From 1970 to 1995, the risk of developing breast cancer increased by 38% in women aged 50-64. All social groups contributed to this increase, the increase being 45% in unskilled workers, and 26% in academics. CONCLUSION: During the last quarter of the 20th century academics had the highest risk of breast cancer in Denmark. The size of the social gradient in breast cancer occurrence depended on the measure used. The time trends in social distribution will result in breast cancer becoming more frequent.

Adult↗

PubMed1997

Predicting future trends in the number of patients on renal replacement therapy in Denmark.

OBJECTIVES: To predict the future prevalence of patients on renal replacement therapy due to chronic renal failure in Denmark. SUBJECTS AND METHODS: Four thousand and nine terminal uraemic patients (median age 50.0 years, 15.2% diabetic) were treated in Denmark with renal replacement therapy in the period 1 January 1991 to 31 December 1995. Incidence rates and rates of transition between the treatment modalities (haemodialysis, peritoneal dialysis, and renal transplantation) were calculated. The prediction was made using a Markov model in three ways: (1) using the average rates (deterministic model), (2) using rates simulated with pseudorandom numbers based on the average rates (stochastic model), and (3) using increasing incidence rates in a deterministic model. RESULTS: Using present rates both model types predicted a significant increase in the prevalence of renal transplant recipients < 60 years (from 1003 in 1995 to about 1465 in 2006) and the prevalence of haemodialysis patients > or = 60 years (from 456 in 1995 to about 903 in 2006) while the prevalence of other treatment modalities would change less dramatically. The overall prevalence proportion would increase from 539 patients per million population (p.m.p.) in 1995 to about 777 p.m.p. in 2006. The stochastic model clearly demonstrated the uncertainties linked to the prognosis in contrast to the deterministic model. The deterministic model with increasing rates predicted a prevalence proportion of 1162 p.m.p. in 2006. CONCLUSION: Even with present rates the prevalence of haemodialysis patients in Denmark will continue to increase. Mathematical models offers a good tool to study future trends and to plan future capacity.

Adult↗

PubMed1990

The effect of a control program for enzootic bovine leukosis. Changes in herd prevalence in Denmark, 1969-1978.

As part of the Danish control program for enzootic bovine leukosis, three hematologic screenings of all cattle herds in Denmark were performed in the period 1969-1978. Herds with multiple cases of persistent lymphocytosis and/or leukotic tumors were classified as "leukosis herds." During nationwide blood testing, 369 leukosis herds were discovered, and an additional 77 herds were found due to follow-up of tumor cases or special testing in connection with movements of cattle in 1969-1978. In the present study, the prevalence of leukosis herds in the three screening rounds is related to geographic area and herd size. By means of a statistical log-linear model, the authors show that prevalence increased proportionally with herd size. The observed number of leukosis herds per 10,000 herds tested declined during the screening program from 105 to 38 in east Denmark and from 12 to 4 in west Denmark.

Animals↗

PubMed2002

Epidemiological investigation of local complications after cosmetic breast implant surgery in Denmark.

Concern has been raised recently regarding the absence of information on the occurrence and severity of local complications after cosmetic breast implantation. The authors evaluated the occurrence of local complications in a large epidemiological retrospective cohort study of women with cosmetic breast implants in Denmark. All women with breast implants were identified from the files of two private clinics of plastic surgery in Denmark. Information on implant characteristics, surgical procedure, as well as short- and long-term complications was obtained through medical record review. Patient characteristics were obtained through a self-administered questionnaire. A total of 754 women (1,572 implants) had at least one cosmetic implantation performed at the study clinics. Average age at implantation was 32 years. Implant types included silicone double lumen with textured surface, 31.2%; silicone single lumen with textured surface, 27.8%; silicone single lumen with smooth surface, 24.5%; silicone double lumen with smooth surface, 0.8%; and other or missing information, 15.7%. Average implant size was 247 ml (range, 110-630 ml). Placement was submuscular for 91.3% of implants, subglandular for 2.6%, and 6.1% had no available information. Overall, 77.8% of implantations were not followed by complications, 17.8% were followed by one complication, 3.6% were followed by two complications, and 0.8% were followed by three or more complications. In 94.6% of implantations, no additional hospitalizations were recorded as a result of complications. Forty-seven of 57 explantations/reimplantations were secondary to postoperative complications. General complications such as hematoma and infection were rare, occurring in 2.3% and 2.0% of implantations respectively. Capsular contracture remains the most common complication, occurring in 11.4% of implantations. In this investigation, among the first epidemiological studies of local complications, the authors found cosmetic breast implant surgery to be associated with a low frequency of normal surgical complications such as infection, hematoma, and wound dehiscence. Most complications were mild and did not lead to additional hospitalization. The complication that led most frequently to the need for additional surgery/hospitalization was capsular contracture. Kjøller K, Hölmich LR, Jacobsen PH, Friis S, Fryzek J, McLaughlin JK, Lipworth L, Henriksen TF, Jørgensen S, Bittmann S, Olsen JH. Epidemiological investigation of local complications after cosmetic breast implant surgery in Denmark.

Adult↗

PubMedDate not supplied

The emergence of penicillinase-producing Neisseria gonorrhoeae strains carrying the 4.9 kb (Toronto) plasmid in Denmark and of a novel large plasmid in two nonpenicillinase-producing Neisseria gonorrhoeae strains.

This study comprised plasmid analysis and antimicrobial susceptibility testing of 712 out of a total of 730 penicillinase-producing Neisseria gonorrhoeae (PPNG) and 744 random non-PPNG strains isolated in Denmark between 1985 and 1990. The rate of patients with PPNG infections rose from 1% to 2% during 1985-1987 to 6.9% in 1989, and then decreased to 4.8% in 1990. A decrease in cases of gonorrhea from 9,798 to 1,990 was seen during the same period. Strains harboring the 4.9 kb (Toronto) plasmid first appeared in 1987; in 1988-1990, 65% to 78% of strains from patients with PPNG infections acquired in Denmark contained this plasmid. The majority of these strains seemed to belong to a single clone. Tetracycline-resistant PPNG strains (MIC greater than 32 mg/L) first appeared in Denmark in 1989, and tetracycline-resistant non-PPNG strains carrying a 40 kb plasmid (tetM?) first appeared in 1990. A novel 41-42 kb plasmid appeared in one strain in 1987 and another in 1988. The minimum inhibitory concentration (MIC) of tetracycline for these two strains was 4 mg/l. The significance of this plasmid is yet unknown.

Ceftriaxone↗