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MRSA in the Ambulance

Nearly half of 21 ambulances in a single fleet tested positive for MRSA.

Transmission of methicillin-resistant Staphylococcus aureus (MRSA) is becoming increasingly common in hospitals, through such fomites as stethoscopes, blood pressure cuffs, and computer terminals. Gyms and prisons are other known sites of MRSA colonization. Researchers assessed whether ambulances are another source of MRSA contamination by collecting swabs from five areas within each of 21 ambulances (16 advanced life support, 3 basic life support, and 2 critical care transport) at two stations from one urban fleet.

At 96 hours after plating, 13 samples isolated from 10 ambulances (12% of swabs, 48% of ambulances) were positive for MRSA. Positive samples were obtained from the steering wheel (1), patient stretcher (4), emergency medical technician work area (7), and Yankauer suction tip (1). The authors note that high patient turnover rates and limited time for equipment sanitation could contribute to MRSA contamination.

Comment: Greatly aided by inappropriate use of antibiotics, MRSA has become ubiquitous, but finding it in ambulances is a condemnation of our current sanitation practices and warns of an excessively casual attitude toward this highly destructive organism. If these findings are reproduced in other emergency medical systems, ambulances would represent an important reservoir for MRSA transmission. Prehospital providers should focus decontamination efforts on interior surfaces of ambulances as well as patient stretchers. Taking measures to decrease transmission of drug-resistant organisms now is critical, before other resistant organisms (such as vancomycin-resistant Enterococcus faecalis) become more prevalent.

— Kristi L. Koenig, MD, FACEP

Published in Journal Watch Emergency Medicine June 8, 2007

Citation(s):

Roline CE et al. Can methicillin-resistant Staphylococcus aureus be found in an ambulance fleet? Prehosp Emerg Care 2007 Apr-Jun; 11:241-4.

• Medline abstract (Free)