Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Katherine E. Atkins, London School of Hygiene and Tropical Medicine
- Second opponent: Associate Professor Andreas Matussek, Karolinska Institutet
- Third member and chair of the evaluation committee: Professor Olav Dalgard, University of Oslo
Chair of the Defence
Professor Ivar Sønbø Kristiansen, University of Oslo
Principal Supervisor
Professor Birgitte Freiesleben de Blasio, University of Oslo
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of infection in healthcare settings. In the past two decades, MRSA has also emerged in the community becoming a serious problem worldwide. The prevalence of MRSA in Norway is among the lowest in the world. Active infection-control strategies as well as low consumption of antibiotics are among the main factors determining this low level of MRSA. However, the global spread observed outside hospitals and the increasing human mobility might represent a serious threat to the control of MRSA.
This thesis aims to obtain a deeper understanding of the transmission dynamics of MRSA in Norway, quantifying the main epidemiological drivers that are shaping the observed increase of cases as well as the connections between community and healthcare settings. For this purpose, we used an integrative approach combining statistical analyses of the Norwegian surveillance data and mathematical modelling of infectious diseases.
Between January 2006 and December 2015 the incidence of MRSA infections in Norway increased by almost a factor of three. The rise mainly affected young individuals and infections acquired abroad. Diversity analyses showed similarities between the dominant spa-types in community and hospital environments, highlighting epidemiological connections between these two settings. The MRSA epidemiology was further investigated by developing an individual-based model reproducing the real socio-demography of Norway. The model estimated a reproduction number below the epidemic threshold and recognized the import of cases from abroad as the main driver of the rising number of infections. Furthermore, the model identified a primary role of households in the MRSA transmission and quantified the importance of implementing infection-control measures in healthcare settings. Coordinated global initiatives are needed to contain the community circulation and the spread of antibiotic resistance worldwide.
Additional information
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