title: Elimination of epidemic methicillin-resistant Staphylococcus aureus from a university hospital and district institutions, Finland.
abstract: From August 1991 to October 1992, two successive outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) occurred at a hospital in Finland. During and after these outbreaks, MRSA was diagnosed in 202 persons in our medical district; >100 cases involved epidemic MRSA. When control policies failed to stop the epidemic, more aggressive measures were taken, including continuous staff education, contact isolation for MRSA-positive patients, systematic screening for persons exposed to MRSA, cohort nursing of MRSA-positive and MRSA-exposed patients in epidemic situations, and perception of the 30 medical institutions in that district as one epidemiologic entity brought under surveillance and control of the infection control team of Turku University Hospital. Two major epidemic strains, as well as eight additional strains, were eliminated; we were also able to prevent nosocomial spread of other MRSA strains. Our data show that controlling MRSA is possible if strict measures are taken before the organism becomes endemic. Similar control policies may be successful for dealing with new strains of multiresistant bacteria, such as vancomycin-resistant strains of S. aureus.
authors.affiliation: Turku University Central Hospital, Turku, Finland. pirkko.kotilainen@utu.fi
authors.forename: Pirkko
authors.initials: P
authors.lastname: Kotilainen
authors.forename: Marianne
authors.initials: M
authors.lastname: Routamaa
authors.forename: Reijo
authors.initials: R
authors.lastname: Peltonen
authors.forename: Jarmo
authors.initials: J
authors.lastname: Oksi
authors.forename: Esa
authors.initials: E
authors.lastname: Rintala
authors.forename: Olli
authors.initials: O
authors.lastname: Meurman
authors.forename: Olli-Pekka
authors.initials: OP
authors.lastname: Lehtonen
authors.forename: Erkki
authors.initials: E
authors.lastname: Eerola
authors.forename: Saara
authors.initials: S
authors.lastname: Salmenlinna
authors.forename: Jaana
authors.initials: J
authors.lastname: Vuopio-Varkila
authors.forename: Tuire
authors.initials: T
authors.lastname: Rossi
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D004196:Disease Outbreaks / Q000517:prevention & control*; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000592:standards; D008503:Medical Staff / Q000592:standards; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification