Determining the risk of antibiotic-resistant bacterial contamination of emergency medical vehicles and paramedic personnel: Conclusions from a helicopter air ambulance case study

The presence of infectious disease-causing microorganisms in emergency medical vehicles presents potential public health risks in view of the multiple millions of ambulance calls that are made worldwide annually. This risk of infection is to the patients, to the patients’ attendants who may also be transported, and to the paramedic personnel whose work involves pre-hospital transfer. This holds true especially for contamination with those pathogenic microorganisms that pose an increased threat due to their known resistance to front-line antimicrobial agents. Identifying the risks may lead to the development of best practices which could optimise infection control on a routine basis and during a large-scale emergency such as a bioterrorism event or pandemic. Our recent preliminary finding of methicillin-resistant Staphylococcus aureus in helicopter air ambulances in Queensland, Australia should provide impetus for a broader scope of investigation of antibiotic-resistant bacterial contamination on a range of emergency medical vehicles. This may warrant the preparation of amended guidelines for best practice in infection control in pre-hospital care cleaning and disinfection to target both a national and international audience among emergency service providers.