Skip to main content Accessibility help
×
Home
Hostname: page-component-59b7f5684b-b2xwp Total loading time: 0.314 Render date: 2022-10-02T22:17:43.111Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "displayNetworkTab": true, "displayNetworkMapGraph": false, "useSa": true } hasContentIssue true

Medical transport-associated infection: Review and commentary making a case for its legitimacy

Published online by Cambridge University Press:  17 December 2020

Diego Schaps
Affiliation:
School of Medicine, Duke University, Durham, North Carolina
Anjni Patel Joiner
Affiliation:
Division of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina Duke Global Health Institute, Duke University, Durham, North Carolina
Deverick J. Anderson*
Affiliation:
Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine, Durham, North Carolina
*
Author for correspondence: Deverick J. Anderson, E-mail: deverick.anderson@duke.edu

Abstract

The purpose of this article is to summarize existing literature about healthcare-associated infection (HAI) in the medical transport environment and to define the term medical transport–associated infection (MTAI) to unify all previous work under a single umbrella with the objective of providing a standardized definition for future research. A review of the literature yielded 34 relevant articles. These studies show that there are pathogens in the ambulance environment, that emergency medical services (EMS) personnel do not regularly comply with hygiene practices, and that patients are potentially affected by HAI as a direct result of ambulance exposure. Prospective studies must be conducted to truly understand the impact that ambulance exposure has on HAIs. MTAI is a subset of HAI and is defined as any infection acquired as a direct effect of exposure in a medical transport setting.

Type
Review
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Report on the Burden of Endemic Health Care-Associated Infection Worldwide. Geneva: World Health Organization; 2011.Google Scholar
National Center for Health Statistics. National Hospital Ambulatory Medical Care Survey: 2017 emergency department summary tables. Centers for Disease Control and Prevention website. https://www.cdc.gov/nchs/data/nhamcs/web_tables/2017_ed_web_tables-508.pdf. Published 2017. Accessed December 8, 2020.Google Scholar
Barr, N, Holmes, M, Roiko, A, Dunn, P, Lord, W. Challenges for environmental hygiene practices in Australian paramedic-led health care: a brief report. Am J Infect Control 2018;46:723725.CrossRefGoogle ScholarPubMed
Lee, JB, Levy, M, Walker, A. Use of a forensic technique to identify blood contamination of emergency department and ambulance trauma equipment. Emerg Med J 2006;23:7375.CrossRefGoogle ScholarPubMed
Teter, J, Millin, MG, Bissell, R. Hand hygiene in emergency medical services. Prehosp Emerg Care 2015;19:313319.CrossRefGoogle ScholarPubMed
Varona-Barquin, A, Ballesteros-Peña, S, Lorrio-Palomino, S, et al. Detection and characterization of surface microbial contamination in emergency ambulances. Am J Infect Control 2017;45:6971.CrossRefGoogle ScholarPubMed
O’Hara, NB, Reed, HJ, Afshinnekoo, E, et al. Metagenomic characterization of ambulances across the USA. Microbiome 2017;5:125.CrossRefGoogle ScholarPubMed
Vikke, HS, Giebner, M. POSAiDA: presence of Staphylococcus aureus/MRSA and Enterococcus/VRE in Danish ambulances: a cross-sectional study. BMC Res Notes 2016;9:194.CrossRefGoogle ScholarPubMed
Vikke, HS, Giebner, M, Kolmos, HJ. Prehospital infection control and prevention in Denmark: a cross-sectional study on guideline adherence and microbial contamination of surfaces. Scand J Trauma Resusc Emerg Med 2018;26:71.CrossRefGoogle ScholarPubMed
Vikke, HS, Giebner, M. UniStatus—a cross-sectional study on the contamination of uniforms in the Danish ambulance service. BMC Res Notes 2015;8:95.CrossRefGoogle ScholarPubMed
Galtelli, M, Deschamp, C, Rogers, J. An assessment of the prevalence of pathogenic microorganisms in the rotor wing air ambulance: one program’s findings. Air Med J 2006;25:8184.CrossRefGoogle ScholarPubMed
Alves, DW, Bissell, RA. Bacterial pathogens in ambulances: results of unannounced sample collection. Prehosp Emerg Care 2008;12:218224.CrossRefGoogle ScholarPubMed
Nigam, Y. and Cutter, J., A preliminary investigation into bacterial contamination of Welsh emergency ambulances. Emerg Med J 2003;20:479482.CrossRefGoogle ScholarPubMed
El-Mokhtar, MA, Hetta, HF. Ambulance vehicles as a source of multidrug-resistant infections: a multicenter study in Assiut City, Egypt. Infect Drug Resist 2018;11:587594.CrossRefGoogle ScholarPubMed
Luksamijarulkul, P, Pipitsangjan, S. Microbial air quality and bacterial surface contamination in ambulances during patient services. Oman Med J 2015;30:104110.CrossRefGoogle ScholarPubMed
Gibson, CV. Emergency medical services oxygen equipment: a fomite for transmission of MRSA? Emerg Med J 2019;36:8991.Google ScholarPubMed
Bielawska-Drozd, A, Cieślik, P, Wlizło-Skowronek, B, et al. Identification and characteristics of biological agents in work environment of medical emergency services in selected ambulances. Int J Occup Med Environ Health 2017;30:617627.Google ScholarPubMed
Merlin, MA, Wong, ML, Pryor, PW, et al. Prevalence of methicillin-resistant Staphylococcus aureus on the stethoscopes of emergency medical services providers. Prehosp Emerg Care 2009;13:7174.CrossRefGoogle ScholarPubMed
Wepler, M, Stahl, W, von Baum, H, et al. Prevalence of nosocomial pathogens in German ambulances: the SEKURE study. Emerg Med J 2015;32:409411.CrossRefGoogle ScholarPubMed
Noh, H, Shin, SD, Kim, NJ, et al. Risk stratification-based surveillance of bacterial contamination in metropolitan ambulances. J Korean Med Sci 2011;26:124130.CrossRefGoogle ScholarPubMed
Orellana, RC, Hoet, AE, Bell, C, et al. Methicillin-Resistant Staphylococcus aureus in Ohio EMS providers: a statewide cross-sectional study. Prehosp Emerg Care 2016;20:184190.CrossRefGoogle ScholarPubMed
Al Amiry, A, Bissell, RA, Maguire, BJ, Methicillin-Resistant, Alves DW. Staphylococcus aureus nasal colonization prevalence among emergency medical services personnel. Prehosp Disaster Med 2013;28:348352.CrossRefGoogle ScholarPubMed
Miramonti, C, Rinkle, JA, Iden, S, et al. The prevalence of methicillin-resistant Staphylococcus aureus among out-of-hospital care providers and emergency medical technician students. Prehosp Emerg Care 2013;17:7377.CrossRefGoogle ScholarPubMed
Fischer, D, Veldman, A, Diefenbach, M, Schäfer, V. Bacterial colonization of patients undergoing international air transport: a prospective epidemiologic study. J Travel Med 2004;11:4448.CrossRefGoogle ScholarPubMed
Ro, YS, Shin, SD, Noh, H, Cho, SI. Prevalence of positive carriage of tuberculosis, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant enterococci in patients transported by ambulance: a single center observational study. J Prev Med Public Health 2012;45:174180.10.3961/jpmph.2012.45.3.174CrossRefGoogle ScholarPubMed
Vikke, HS, Vittinghus, S, Betzer, M, et al. Hand hygiene perception and self-reported hand hygiene compliance among emergency medical service providers: a Danish survey. Scand J Trauma Resusc Emerg Med 2019;27:10.CrossRefGoogle ScholarPubMed
McGuire-Wolfe, C, Haiduven, D, Hitchcock, CD. A multifaceted pilot program to promote hand hygiene at a suburban fire department. Am J Infect Control 2012;40:324327.CrossRefGoogle Scholar
Khan, AA. Emergency medical services providers’ experiences and attitudes toward infection prevention and control measures in Saudi Arabia: a qualitative study. Disaster Med Public Health Prep 2019. doi: 10.1017/dmp.2019.108.Google ScholarPubMed
Bucher, J, Donovan, C, Ohman-Strickland, P, McCoy, J. Hand washing practices among emergency medical services providers. West J Emerg Med 2015;16:727735.CrossRefGoogle ScholarPubMed
Hubble, MW, Zontek, TL, Richards, ME. Predictors of influenza vaccination among emergency medical services personnel. Prehosp Emerg Care 2011;15:175183.CrossRefGoogle ScholarPubMed
Bledsoe, BE, Sweeney, RJ, Berkeley, RP, Cole, KT, Forred, WJ, Johnson, LD. EMS provider compliance with infection control recommendations is suboptimal. Prehosp Emerg Care 2014;18:290294.CrossRefGoogle ScholarPubMed
Stuart, RL, Cameron, DRM, Scott, C, et al. Peripheral intravenous catheter-associated Staphylococcus aureus bacteraemia: more than 5 years of prospective data from two tertiary health services. Med J Aust 2013;198:551553.CrossRefGoogle ScholarPubMed
Alter, SM, Merlin, MA. Nosocomial and community-acquired infection rates of patients treated by prehospital advanced life support compared with other admitted patients. Am J Emerg Med 2011;29:5764.CrossRefGoogle ScholarPubMed
Disinfection and sterilization. Centers for Disease Control and Prevention website. https://www.cdc.gov/infectioncontrol/guidelines/disinfection/index.html. Published 2019. Accessed November 11, 2020.Google Scholar
Emanuelsson, L, Karlsson, L, Castrèn, M, Lindström, V. Ambulance personnel adherence to hygiene routines: still protecting ourselves but not the patient. Eur J Emerg Med 2013;20:281285.CrossRefGoogle Scholar
Vikke, HS, Vittinghus, S, Giebner, M, et al. Compliance with hand hygiene in emergency medical services: an international observational study. Emerg Med J 2019;36:171175.CrossRefGoogle Scholar
Ho, JD, Ansari, RK, Page, D. Hand sanitization rates in an urban emergency medical services system. J Emerg Med 2014;47:163168.CrossRefGoogle Scholar
1
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Medical transport-associated infection: Review and commentary making a case for its legitimacy
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Medical transport-associated infection: Review and commentary making a case for its legitimacy
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Medical transport-associated infection: Review and commentary making a case for its legitimacy
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *