Outbreak of Methicillin-resistant Staphylococcus aureus in a Norwegian Hospital

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Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) occurred sporadically in Norwegian hospitals in the 1960s and 1970s, but disappeared in the late 1970s for unknown reasons. Only 1 outbreak has subsequently been reported. We describe herein a second outbreak in a different hospital, this time featuring a more resistant strain. Staff and patients were screened immediately after detection of the first MRSA isolate. Colonized and infected patients were nursed using contact precautions, and the staff were not allowed to work until 3 nose samples were MRSA-negative. We treated colonized persons with topical administration of mupirocin to the nostrils and a chlorhexidine body wash. The outbreak affected 7 patients and 5 healthcare workers. Pulsed-field gel electrophoresis proved all isolates to be of the same type, and the MRSA phage type was M3. There was no sign of transmission of MRSA after contact precautions were implemented. MRSA was eradicated in 4 of the patients and all 5 healthcare workers. One patient died and 1 was still colonized 3 y after onset of the outbreak. Contact precautions proved to be sufficient to prevent transmission of MRSA.