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CC BY-NC-ND 4.0 · J Lab Physicians 2021; 13(03): 202-207
DOI: 10.1055/s-0041-1730848
Original Article

Bacteriological Surveillance of Ambulance Vehicles from a Tertiary Care Hospital of North India

Shiwani Sharma 
1   Department of Microbiology, Gian Sagar Medical College, Rajpura, Punjab, India
,
Priya Datta
2   Department of Medical Parasitology, PGIMER, Chandigarh, India
,
Varsha Gupta 
3   Department of Microbiology, Government Medical College Hospital, Chandigarh, India
,
Dipanshu Vasesi
3   Department of Microbiology, Government Medical College Hospital, Chandigarh, India
,
Jagdish Chander
3   Department of Microbiology, Government Medical College Hospital, Chandigarh, India
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Abstract

Objective An ambulance is a medically equipped vehicle which is used in case of any medical emergency for the transport of patients to treatment facilities. The ambulances help in the transportation of thousands of patients per year, and such patients may carry infectious microorganisms which pose a major threat to the treatment of such patients. In this study, we analyzed the extent of bacterial contamination in our ambulance vehicles and measured the degree of antimicrobial resistance among isolated pathogens.

Material and Method This study included five ambulances of our tertiary care hospital and different random sites were swabbed in each vehicle. These were selected based on their well-known high frequency of contact by emergency personnel and patients. Swabs were inserted into sterile test tubes containing normal saline and immediately transferred to our microbiology laboratory to identify bacterial contaminants utilizing standard microbiological procedures.

Result A total of 198 swab samples were collected from all the five ambulances, out of which 170 (85.8%) swabs were sterile and 28 (14.2%) swabs yielded potentially pathogenic bacterial isolates. The highest contamination rate with pathogenic bacteria was detected in the oxygen flow meter knob (60%), suction machine tubing (60%), and stethoscope (40%). Staphylococcus aureus (32%) was the most frequently detected microorganism.

Conclusion Our study showed low prevalence of bacterial contamination in ambulances because of good infection control policy of our hospital, however, some areas still need improvement and require proper standard operating procedures of disinfection policies of these emergency vehicles.

Keywords

ambulance - disinfection - infectious microorganisms - multidrug resistant


Publication History

Article published online:
18 June 2021

© 2021. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Skinner HA. “The Origin of Medical Terms”. Baltimore: Williams & Wilkins 1949
  • 2 Barkley KT. The Ambulance. New York: Exposition Press 1990
  • 3 National Health Systems Resource Centre (NHSRC). Study of Emergency Response Service—EMRI Model. Report by the Ministry of Health & Family Welfare, Government of India; 2009
  • 4 Srinivasan A, Song X, Ross T, Merz W, Brower R, Perl TM. A prospective study to determine whether cover gowns in addition to gloves decrease nosocomial transmission of vancomycin-resistant enterococci in an intensive care unit. Infect Control Hosp Epidemiol 2002; 23 (08) 424-428
    CrossrefPubMedGoogle Scholar
  • 5 Occupational Health and Safety Administration. Personal Protective Equipment. Document#3151. Available at: http://www.osha.gov/index.html. Accessed October 20, 2005
  • 6 Collee JG, Miles RS, Watt B. Tests for the identification of bacteria. In: Collee JG, Fraser AG, Marmion BP, Simmons A, eds. Mackie & MacCartney Practical Medical Microbiology. 14th ed. London: Churchill Livingstone 1996: 151-179
  • 7 Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Twenty First Informational Supplement M100–S21. Wayne, PA: CLSI; 2019
    Google Scholar
  • 8 Alrazeeni D, Al Sufi MS, Sufi A. Nosocomial infections in ambulances and effectiveness of ambulance fumigation techniques in Saudi Arabia. Phase I study. Saudi Med J 2014; 35 (11) 1354-1360
    PubMedGoogle Scholar
  • 9 Brown R, Minnon J, Schneider S, Vaughn J. Prevalence of methicillin-resistant Staphylococcus aureus in ambulances in southern Maine. Prehosp Emerg Care 2010; 14 (02) 176-181
    CrossrefPubMedGoogle Scholar
  • 10 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 (02) 184-190
    CrossrefPubMedGoogle Scholar
  • 11 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
    CrossrefPubMedGoogle Scholar
  • 12 Datta P, Gulati N, Singla N. et al Evaluation of various methods for the detection of methicillin-resistant Staphylococcus aureus strains and susceptibility patterns. J Med Microbiol 2011; 60 (Pt 11) 1613-1616
    CrossrefPubMedGoogle Scholar
  • 13 Eibicht SJ, Vogel U. BEibicht SJ. Methicillin-resistant Staphylococcus aureus (MRSA) contamination of ambulance cars after short term transport of MRSA-colonised patients is restricted to the stretcher. J Hosp Infect 2011; 78 (03) 221-225
    CrossrefPubMedGoogle Scholar
  • 14 Roline CE, Crumpecker C, Dunn TM. Can methicillin-resistant Staphylococcus aureus be found in an ambulance fleet?. Prehosp Emerg Care 2007; 11 (02) 241-244
    CrossrefPubMedGoogle Scholar
  • 15 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: 587-594
    CrossrefPubMedGoogle Scholar
  • 16 Nigam Y, Cutter J. A preliminary investigation into bacterial contamination of Welsh emergency ambulances. Emerg Med J 2003; 20 (05) 479-482
    CrossrefPubMedGoogle Scholar
  • 17 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 (01) 71-74
    CrossrefPubMedGoogle Scholar
  • 18 Muto CA, Jernigan JA, Ostrowsky BE. et al SHEA. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus. Infect Control Hosp Epidemiol 2003; 24 (05) 362-386
    CrossrefPubMedGoogle Scholar
  • 19 Treakle AM, Thom KA, Furuno JP, Strauss SM, Harris AD, Perencevich EN. Bacterial contamination of health care workers’ white coats. Am J Infect Control 2009; 37 (02) 101-105
    CrossrefPubMedGoogle Scholar
  • 20 Wiener-Well Y, Galuty M, Rudensky B, Schlesinger Y, Attias D, Yinnon AM. Nursing and physician attire as possible source of nosocomial infections. Am J Infect Control 2011; 39 (07) 555-559
    CrossrefPubMedGoogle Scholar
  • 21 Calà C, Amodio E, Di Carlo E, Virruso R, Fasciana T, Giammanco A. Biofilm production in Staphylococcus epidermidis strains, isolated from the skin of hospitalized patients: genetic and phenotypic characteristics. New Microbiol 2015; 38 (04) 521-529
    PubMedGoogle Scholar
  • 22 Sehulster L, Chinn RY. CDC. Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep 2003; 52 (RR-10) 1-42
    PubMedGoogle Scholar