The Public Health Agency of Sweden
Updated 14 June 2018

Surveillance of antibacterial resistance

The Public Health Agency of Sweden is responsible for national monitoring of antibacterial resistance and use of antibiotics in human medicine, with support from local and regional experts. Data is also communicated regularly to laboratories, Strama groups, the healthcare sector, policy makers and the media.

Four types of antibiotic-resistant bacteria are monitored according to the Communicable Diseases Act and epidemiological typing is carried out on all notifiable forms of resistance.

Sweden is actively working for a quality-assured methodology for surveillance of antibacterial resistance. Comparing the occurrence of antibiotic resistance between different laboratories over time requires common susceptibility breakpoints and Sweden has used those established by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) for many years.

Four systems used in national surveillance


Annual resistance monitoring and quality assurance online. Since 1994, participating laboratories submit susceptibility testing data to this web-based programme and are able to observe resistance locally and nationally, and continuously assess the quality of their own antibiotic susceptibility testing methods.


European resistance monitoring of invasive infections, coordinated by ECDC, a programme that has an important role in informing about the occurrence and spread of antibiotic resistance in Europe. Sweden contributes with national resistance data covering approximately 80 per cent of the population.


Continuous monitoring of resistance. SmiNet is a web-based programme that receives and manages notifications from treating physicians and laboratories. Resistance is reported on a daily basis and can be monitored continuously, unlike in EARS-Net and ResNet.


A national IT system for early alerts and continuous resistance monitoring. The system is based on all results from cultures being transferred on a daily basis from microbiological laboratories for early warnings and local feedback. Resistance monitoring in Sweden is mainly done on a voluntary basis and has good geographic coverage. The Public Health Agency of Sweden and the National Veterinary Institute analyse and compile national data on antibiotic sales and resistance in an annual report, SWEDRES/SVARM (published in English).

Read more in the report Swedish work on containment of antibiotic resistance.