Is an increase of MRSA in Oslo, Norway, associated with changed infection control policy?

J Infect. 2007 Dec;55(6):531-8. doi: 10.1016/j.jinf.2007.09.008.

Abstract

Objectives: The objective was to describe the prevalence of MRSA in Oslo, Norway, before and after introduction of a new National MRSA Control Guideline.

Methods: From 1993 to 2006, we prospectively collected clinical and microbiological data on all MRSA cases in Oslo, Norway. Two MRSA guidelines; a strict Ullevål Standard MRSA Guideline and a less strict National MRSA Control Guideline were compared.

Results: During 1993-2006, 358 MRSA cases were registered in Oslo; 43.9% detected in Ullevål University Hospital, 21.2% in nursing homes, and 18.7% in primary healthcare. One out of three (30.4%) were import-associated, and one out of ten (11.2%) were healthcare personnel. From 2004 on, a new National MRSA Control Guideline was introduced in primary healthcare, served by the community infection control. From 2004 on, there was a 4-6-fold increase of MRSA in primary healthcare (p = 0.038) and nursing homes (p = 0.005). Increase of MRSA cases at Ullevål (p < 0.001) was import-associated or from outbreaks in primary healthcare. There was no increase of internal spread in the hospital.

Conclusion: These data indicate that perhaps a less strict national MRSA infection control guideline in Norway may be associated with the 4-6-fold increase of MRSA cases in the community after 2003.

MeSH terms

  • Disease Outbreaks
  • Guidelines as Topic*
  • Hand / microbiology
  • Humans
  • Infection Control / legislation & jurisprudence*
  • Infection Control / standards
  • Mass Screening / methods
  • Methicillin Resistance / physiology*
  • Norway / epidemiology
  • Nose / microbiology
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / drug effects*
  • Staphylococcus aureus / growth & development
  • Staphylococcus aureus / isolation & purification