Contamination of emergency medical vehicles and risk of infection to paramedic first responders and patients by antibiotic-resistant bacteria: Risk evaluation and recommendations from ambulance case studies

Contamination of emergency medical vehicles with pathogenic microbes poses a potential threat to public health considering the many millions of ambulance responses that are made globally each year. This risk of infection is to the patients, to their companions who may travel with them, and to the paramedic first responders whose work involves pre- or inter-hospital transfer. This applies particularly to contamination by those infectious disease-causing microbes for which the threat is heightened because of their recognised resistance to leading antimicrobial agents. Determining the risks should facilitate the advancement of best practices to enhance infection control of routine outbreaks and during a major emergency such as a disease pandemic or a bioterrorism event. This may merit the introduction of amended guidelines for ambulance cleaning and disinfection to achieve more effective pre-hospital infection control among the worldwide community of emergency service providers.