Bacterial Pathogens in Ambulances: Results of Unannounced Sample Collection

Abstract

The concern that the health care environment may harbor a substantial reservoir of infectious agents has been vigorously examined by microbiology andinfectious disease experts. Although universal precautions anddisposable equipment reduces risks to patients andproviders, the ambulance remains vulnerable to bacterial contamination from biological secretions. Additionally, the nature of emergency medical services creates pressures on prehospital care providers. Objective. We hypothesized that a discrepancy exists between the expectation of disinfection of reusable equipment in emergency medical services (EMS) andthe cleaning that actually occurs. Methods. We chose five areas within the ambulance for specimen collection for their reasoned propensity to yield a large spectrum of bacteria. Four first-due ambulances were selected for culturing. The crews did not have advance knowledge of the study or sample collection. Specific identifications with antibiotic susceptibility were completed, identifying three multidrug resistant organisms. Results. Specimens from all four ambulances grew moderate-to-large quantities of environmental andskin flora. Newer, automated microbiological techniques andconcerns regarding multiple-drug-resistant organism prevalence as well as the potential for biological warfare make complete identification more important. Conclusions. This study examined the bacterial pathogens found in EMS vehicles. Four of the seven species isolated were substantial nosocomial pathogens, andthree of these four possess formidable antibiotic resistance patterns. All of the organisms detected are susceptible to the disinfectant agents currently in common use by EMS agencies.

Key words:

• nosocomial
• EMS
• pathogen
• contamination
• infections