Human AMR Surveillance
Human AMR surveillance across the Nordic countries is built on clinical microbiology laboratory data, national registries, and standardised susceptibility testing using EUCAST breakpoints.
How It Works
Each Nordic country collects AMR data from:
- Clinical microbiology laboratories - AST on isolates from hospitals and primary healthcare
- National registries - Mandatory notification systems for resistant organisms
- Reference laboratories - Detailed characterisation of high-priority pathogens
Country-by-Country Overview
Denmark
- Broad surveillance via DANMAP: invasive and non-invasive pathogens
- Primary care data + hospital-level granularity
- Routine Whole-Genome Sequencing (WGS) for many pathogens
- Data collected by SSI with sample metadata
Finland
- FiRe laboratories network (since 1992), coordinated by THL
- NIDR - mandatory notification for 40 infectious diseases
- Open-access database at sampo.thl.fi
Iceland
- Nationwide system coordinated by the Chief Epidemiologist
- Data from Landspitali University Hospital
Norway
- NORM coordinated by UNN
- 25+ years of protocol-defined yearly surveys
- New national microbiology database under development
- NIPH manages national notification system (MSIS)
Sweden
- Automatic reporting from clinical labs to SmiNet and Svebar databases
- Managed by Folkhälsomyndigheten
- Routine surveillance for ESBL-producing E. coli (community resistance insight)
International Reporting
All Nordic countries report to:
- EARS-Net (European Antimicrobial Resistance Surveillance Network)
- EpiPulse Cases (formerly TESSy)
- WHO GLASS
Challenges
- AST Reporting - Loss of quantitative data in S/I/R reporting
- Clinical Isolate-Diagnosis Link - Disconnection between lab results and patient records
- Sampling Bias - Over-representation of hospital data