Laboratory Medicine and Nosocomial Infections: How Norway Reduces MRSA

Norwegian hospitals have had considerable success in their anti-methicillin-resistant Staphylococcus aureus (MRSA) efforts.

The country introduced strict control on antibiotic use that resulted in far fewer cases of the MRSA infections. An estimated 19,000 patients in U.S. hospitals died each year following MRSA infection, and observers are suggesting that the U.S. healthcare system could reduce those cases by replicating the Scandinavian country's control program.

How does Norway do it? Norwegian doctors prescribe fewer antibiotics than any other country, so people do not have a chance to develop resistance to them. Patients with MRSA are isolated and medical staff members who test positive stay at home. Doctors track each case of MRSA by its individual strain, interviewing patients about where they have been and who they have been with testing anyone who has been in contact with them.

"It's a very sad situation that in some places so many are dying from this, because we have shown here in Norway that methicillin-resistant Staphylococcus aureus can be controlled, and with not too much effort," said Jan Hendrik-Binder, Oslo's MRSA medical adviser. "But you have to take it seriously, you have to give it attention, and you must not give up."

Now a spate of new studies from around the world proves that Norway's model can be replicated with extraordinary success, and public health experts are saying deaths from MRSA are unnecessary.

In a small public hospital called the Queen Elizabeth Hospital Kings Lynn, NHS Trust (UK), about 100 miles outside of London (UK) microbiologist Prof. Lynne Liebowitz noticed the low Nordic MRSA rates, while the numbers in her hospital were increasing.

Prof. Liebowitz asked doctors to stop almost completely using two groups of antibiotics (fluoroquinolones and/or cephalosporins) known for provoking MRSA infections. One month later, MRSA rates were tumbling. In 2003, when the study started the hospital had 47 MRSA bloodstream infections. In 2008, they had one. This has been replicated at four other hospitals, all with the same results.

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Queen Elizabeth Hospital Kings Lynn