title: Risk stratification-based surveillance of bacterial contamination in metropolitan ambulances.
abstract: We aimed to know the risk-stratification-based prevalence of bacterial contamination of ambulance vehicle surfaces, equipment, and materials. This study was performed in a metropolitan area with fire-based single-tiered Basic Life Support ambulances. Total 13 out of 117 ambulances (11.1%) were sampled and 33 sites per each ambulance were sampled using a soft rayon swab and aseptic containers. These samples were then plated onto a screening media of blood agar and MacConkey agar. Specific identification with antibiotic susceptibility was performed. We categorized sampling sites into risk stratification-based groups (Critical, Semi-critical, and Non-critical equipment) related to the likelihood of direct contact with patients' mucosa. Total 214 of 429 samples showed positive results (49.9%) for any bacteria. Four of these were pathogenic (0.9%) (MRSA, MRCoNS, and K. pneumoniae), and 210 of these were environmental flora (49.0%). However, the prevalence (positive/number of sample) of bacterial contamination in critical, semi-critical airway, semi-critical breathing apparatus group was as high as 15.4% (4/26), 30.7% (16/52), and 46.2% (48/104), respectively. Despite current formal guidelines, critical and semi-critical equipments were contaminated with pathogens and normal flora. This study suggests the need for strict infection control and prevention for ambulance services.
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Noh
authors.forename: Sang Do
authors.initials: SD
authors.lastname: Shin
authors.forename: Nam Joong
authors.initials: NJ
authors.lastname: Kim
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Ro
authors.forename: Hyang Soon
authors.initials: HS
authors.lastname: Oh
authors.forename: Se Ik
authors.initials: SI
authors.lastname: Joo
authors.forename: Jung In
authors.initials: JI
authors.lastname: Kim
authors.forename: Marcus Eng Hock
authors.initials: ME
authors.lastname: Ong
mesh_terms: D000328:Adult; D000368:Aged; D000552:Ambulances; D001419:Bacteria / Q000254:growth & development / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000175:diagnosis; D004632:Emergency Medical Services; D004866:Equipment Contamination; D004864:Equipment and Supplies / Q000382:microbiology*; D005260:Female; D006801:Humans; D017053:Infection Control; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012307:Risk Factors