30 years of monitoring show that antibiotic resistance can be pushed back
Targeted interventions can significantly reduce the prevalence of specific antibiotic-resistant bacteria, as 30 years of monitoring of antibiotic use and resistance through the DANMAP programme demonstrate.
Photo: Colourbox
Thursday 24 September 2026
In a world where antibiotic resistance remains a serious challenge, the DANMAP surveillance programme aims to provide a strong basis for identifying where action is needed.
DANMAP, a collaboration between the DTU National Food Institute and Statens Serum Institut (SSI), celebrates its 30th anniversary this year. Over three decades, the close collaboration between the two institutions has made it possible to collect and compare data from humans, animals and food.
The anniversary also provides an opportunity to consider how surveillance should evolve in the coming years, including through the integration of additional data sources and the adoption of an even stronger One Health approach, in which human, animal and environmental health are considered together.
“We are striving to become even better at collecting and understanding data across humans, animals and food. This will help us to preserve antibiotics as an effective treatment for bacterial infections in animals and humans, and thereby also protect both animal and public health,” says Sofia Ribeiro Duarte, senior researcher at the DTU National Food Institute, adding:
“At the same time, we will systematically monitor whether Denmark is moving in the right direction in relation to the targets set out in the national action plans on antibiotic resistance published in recent years.”
See links to the action plans under ‘Read more’.
Valuable institutional memory
In addition to a stronger One Health focus, data must be interpreted more holistically across different data sources.
“Over the 30 years we have built up a record, which only becomes more valuable with time. Since 2018, we have worked on linking health data with genetic analyses for faster outbreak detection and surveillance. We will continue to develop this, but at the same time we want to develop systems that link antibiotic use with resistance data, both within and across sectors,” says Ute Wolff Sönksen, chief physician at Statens Serum Institut.
Part of this work involves making data and findings more visually clear. DANMAP Explorer already provides digital access to more than 25 years of historical resistance data from animals and food. The aim for the future is to make data available more quickly, so that changes can be detected earlier and information from different areas can be more easily viewed in context.
More patients linked to outbreaks of multidrug-resistant bacteria
A current example of how data can be used across disciplines can be found in hospitals.
Here, researchers are monitoring, for example, CPO bacteria. These are bacteria that produce enzymes which can make them resistant to carbapenems – antibiotics used to treat serious infections in humans.
In 2024, 166 new patients were linked to CPO outbreaks in Denmark. Using whole-genome sequencing – a detailed mapping of the bacteria’s genetic material – researchers can compare bacteria from different patients and hospitals. Cases that initially appear to be separate may thus turn out to be part of the same outbreak.
“DANMAP is a vital part of Denmark’s preparedness against antibiotic resistance, and as healthcare systems, transmission routes or food production change, surveillance must adapt to the risks. The next major challenge in terms of resistance may well look very different from the one that originally led to the establishment of DANMAP,” says Ute Wolff Sönksen.
Surveillance of CPO therefore also continues in the animal and food sectors, as CPO bacteria have been found in food products abroad in recent years.
“When we find resistant bacteria in humans, one of the key questions is whether they may be linked to livestock, to meat in the supermarket or to entirely different sources. By comparing data from humans, animals and food, we can get closer to the answer and thus also to where it makes the most sense to take action,” says Sofia Ribeiro Duarte from the DTU National Food Institute.
Since 2014, DANMAP has systematically investigated whether CPO bacteria are present in animals and food in Denmark, but none have been detected to date.
Chicken demonstrates the value of monitoring
A clear example of the value of DANMAP can be seen in Danish chicken production.
In 2011, cephalosporin-resistant E. coli bacteria were found in 44% of samples of Danish chicken meat, even though the cephalosporin class of antibiotics had not been used in Danish broiler production for at least ten years.
Studies suggested that the bacteria might have entered Denmark via imported breeding stock. When the use of the antibiotics in question was discontinued further up the international breeding chain, the prevalence fell significantly. In 2024, E. coli bacteria with similar resistance traits were found in only 2% of samples of Danish chicken meat.
This train of events helps to underline the value of being able to track developments over many years. When researchers can compare the same types of data year-on-year, they are not only able to identify a resistance problem; they can also investigate possible causes and monitor changes once measures have been taken to address a specific challenge.
About DANMAP
In 1995, Denmark became the first country in the world to establish an integrated surveillance system for antibiotic use and resistance across humans, animals and food. DANMAP has since served as a model for similar programmes in other countries.
The DANMAP report will be published in autumn 2026 for the 30th time.
