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dc.contributor.authorElstrøm, Petter
dc.contributor.authorAstrup, Elisabeth
dc.contributor.authorHegstad, Kristin
dc.contributor.authorSamuelsen, Ørjan
dc.contributor.authorEnger, Hege
dc.contributor.authorKacelnik, Oliver
dc.date.accessioned2019-09-20T13:33:43Z
dc.date.available2019-09-20T13:33:43Z
dc.date.issued2019-02-04
dc.description.abstract<p><i>Introduction - </i>Scandinavian countries have traditionally had a low prevalence of resistant organisms, but have in recent years experienced a change in their epidemiology. We aim to describe the epidemiology of carbapenemase-producing organisms (CPOs), vancomycin-resistant enterococci (VRE) and methicillin-resistant <i>S. aureus</i> (MRSA) in Norway, measure the importance of infections contracted abroad, and assess the morbidity and mortality associated with these resistant bacteria in Norway. <p><i>Methods and materials - </i>We used data from the Norwegian surveillance system for communicable diseases covering all findings of the selected resistant bacteria including both infections and colonisation, in the period 2006–2017. Annual trends were assessed using negative binomial regression. For MRSA, we were able to calculate the Morisita-Horn index and transmission numbers following importation in order to assess the effect this had on further domestic transmission. <p><i>Results - </i>The incidence rates (per 100,000 personyears) of the three groups of resistant bacteria have increased during the period. In 2017 the incidence rates were 0.82 for CPOs, 7.09 for VRE and 43.8 for MRSA. 81% of CPO cases were diagnosed in hospitals, but 73% were infected abroad. Most VRE cases were infected in Norwegian hospitals, 85% were associated with hospitals outbreaks. MRSA was predominantly diagnosed in the community, only 21% were diagnosed in hospitals. Of all MRSA cases, 35% were infected in other countries. Most MRSA <i>spa</i>-types were not identified again after introduction, resulting in a transmission of MRSA equivalent to a mean of 0.30 persons infected from each <i>spa</i>-type identified (range: 0–22). The proportion of infections among all notified cases within each diagnose was 44% for MRSA, 9% for VRE and 45% for CPOs. Among persons notified with bacteraemia, the 30 days all-cause mortality were 20%, 16% and 50% for MRSA, VRE and CPOs respectively. <p><i>Discussion - </i>The incidence rates of CPOs, VRE and MRSA in Norway are low, but increasing. The continuing increase of notified resistant bacteria highlights the need for a revision of existing infection prevention and control guidelines.en_US
dc.descriptionSource at <a href=https://doi.org/10.1371/journal.pone.0211741>https://doi.org/10.1371/journal.pone.0211741</a>.en_US
dc.identifier.citationElstrøm, P., Astrup, E., Hegstad, K., Samuelsen, Ø., Enger, H. & Kacelnik, O. (2019). The fight to keep resistance at bay, epidemiology of carbapenemase producing organisms (CPOs), vancomycin resistant enterococci (VRE) and methicillin resistant Staphylococcus aureus (MRSA) in Norway, 2006-2017. <i>PLoS ONE, 14</i>(2), e0211741. https://doi.org/10.1371/journal.pone.0211741en_US
dc.identifier.cristinIDFRIDAID 1690517
dc.identifier.doi10.1371/journal.pone.0211741
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/10037/16244
dc.language.isoengen_US
dc.publisherPLOSen_US
dc.relation.journalPLoS ONE
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803en_US
dc.titleThe fight to keep resistance at bay, epidemiology of carbapenemase producing organisms (CPOs), vancomycin resistant enterococci (VRE) and methicillin resistant Staphylococcus aureus (MRSA) in Norway, 2006-2017en_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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