title: Prevalence of nosocomial pathogens in German ambulances: the SEKURE study.
abstract: OBJECTIVE
  The increasing prevalence of multidrug resistant bacteria is a problem in the inpatient care setting, and in the emergency care system. The aim of this observational, cross-sectional study was to evaluate the prevalence of pathogens on well-defined surfaces in German ambulances that have been designated as 'ready for service'.
  
  
  METHODS
  After informed consent was obtained, ambulance surfaces were sampled with agar plates for microbiological examination during an unannounced visit. A standardised questionnaire was used to obtain information regarding the disinfection protocols used at each rescue station.
  
  
  RESULTS
  Methicillin resistant staphylococcus aureus contamination was present in 18 sampling surfaces from 11 out of 150 ambulance vehicles (7%) that were designated as ready for service. Contact surfaces directly surrounding patients or staff were most frequently contaminated with pathogens. However, bacterial contamination was not related to annual missions, methods or frequency of disinfection.
  
  
  CONCLUSIONS
  In accordance with previous studies, disinfection and cleaning of areas with direct contact to patients or staff seem to be the most challenging. This should also be reflected in disinfection guidelines and the related continuing education.
authors.affiliation: Department of Anaesthesiology, University Hospital Ulm, Ulm, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Wepler
authors.affiliation: Department of Anaesthesiology, University Hospital Ulm, Ulm, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Stahl
authors.affiliation: Institute of Medical Microbiology and Hygiene, University Hospital Ulm, Ulm, Germany.
authors.forename: H
authors.initials: H
authors.lastname: von Baum
authors.affiliation: Institute of Medical Microbiology and Hygiene, University Hospital Ulm, Ulm, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Wildermuth
authors.affiliation: Department of Anaesthesiology, University Hospital Ulm, Ulm, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Dirks
authors.affiliation: Department of Anaesthesiology, University Hospital Ulm, Ulm, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Georgieff
authors.affiliation: Department of Anaesthesiology, University Hospital Ulm, Ulm, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Hafner
mesh_terms: D000362:Agar; D000552:Ambulances; D001419:Bacteria / Q000302:isolation & purification*; D003428:Cross Infection / Q000517:prevention & control; D003430:Cross-Sectional Studies; D003470:Culture Media; D004866:Equipment Contamination; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D015995:Prevalence
chemical_list: D003470:Culture Media; D000362:Agar
keywords: bacterial; infectious diseases; management, emergency department management; prehospital care; risk management