Maren Sogstad

Molecular Characterization of Non-Penicillin-Susceptible Streptococcus pneumoniae in Norway

ABSTRACT A total of 125 non-penicillin-susceptible Streptococcus pneumoniae isolates were received at the Norwegian Institute of Public Health in the period from 1995 to 2001. The strains were tested for antimicrobial susceptibility, serotyped, and genotyped by multilocus sequence typing (MLST); and their penicillin-binding proteins (PBPs) were typed by restriction fragment length polymorphism analysis of their pbp genes. Of the 125 strains, 48 (38%) were fully resistant to penicillin and 77 (62%) were intermediately resistant to penicillin. Most of the strains resistant to penicillin were also resistant to one or several additional antibiotics. The most frequent serotypes among the non-penicillin-susceptible strains were 14, 9V, 19F, 23F, and 6B. MLST analysis showed a high degree of genetic diversity among the 119 strains tested, with a total of 74 different sequence types. Six of the 26 internationally known resistant clones were present; the Spain9V-3 clone was the most frequent, with 19 isolates. A total of 74 (62%) of the isolates were related to 1 of the 26 international clones. Restriction enzyme analyses of the pbp1a, pbp2b, and pbp2x genes revealed 12, 12, and 19 different patterns, respectively; and a total of 43 different PBPs types were demonstrated. Our data indicate that the non-penicillin-susceptible strains in Norway are highly diverse genetically and that limited spread of the internationally known resistant strains occurred in the country in the period examined.

Voluntary Work in the Norwegian long-term Care Sector: Complementing or substituting formal Services?

ABSTRACT Across Europe, governments call for increased involvement of volunteers to shoulder some of the welfare burden. Nevertheless, there is little research into what kind of work and how much volunteers currently contribute in the long-term care services and whether this has the potential to substitute formal services. Drawing on findings from a survey of employees in Norwegian nursing homes and home care districts, we examine the nature and volume of voluntary, unpaid work in the long-term care services in Norway. Our data suggest that volunteers to a very limited degree carry out work that has traditionally been considered the formal system’s domain: personal care and practical help. Nearly all the voluntary, unpaid contributions in our data takes place within cultural, social and other activities aimed at promoting mental stimulation and well-being, indicating a classic specialisation of tasks between volunteers and professionals. However, there has been an expansion of the formal care system to include activities aimed at promoting well-being in recent decades. This may indicate that there is a certain level of task sharing between voluntary and formal care. Thus, social workers need to consider voluntary service provision when assessing the needs of clients.