1200. Measuring the Contamination of Transport and Emergency Ambulances and Emergency Medical Service (EMS) Providers

Abstract

Abstract Background Contamination of ambulances and EMS providers is poorly understood. Methods We conducted a prospective observational study to determine contamination of ambulances and EMS providers at two agencies in central North Carolina. Study ambulances and providers were enrolled and sampled prior to the start of day shift on each sampling day. Ambulances were then disinfected with bleach by a study member. Ambulances and providers were sampled again immediately following shift completion and before final disinfection. Samples were obtained from ambulances and providers (Table 1). Cellulose sponges and flocked swabs used for sampling were pre-drenched with disinfectant neutralizing buffer. RODAC plates for clothing cultures were filled with disinfectant neutralizing agar. Sponges were processed using the stomacher method, swabs were plated onto media directly, and RODACs were read and worked up using standard microbiology techniques. All samples were plated on general and selective media for study pathogens. We calculated total colony forming units (CFU), total CFU for each sample area and proportions of samples harboring clinically important pathogens (CIPs), defined as MRSA, MSSA, and VRE. The Mann-Whitney U test was used to compare CFUs between samples, ambulances, and providers, and the Z score proportionality test was used to compare proportions of samples with CIPs. P < .05 was considered significant. Table 1.Sampling Methods and Locations of Ambulance and EMS Providers Results 10 emergency and 10 transport ambulances, and 40 providers were sampled from September 2021 - March 2022 resulting in 980 total samples. Transport and emergency truck CFUs (Table 2) were similar between sample 1 and 2 (p=0.1, 0.9, respectively). EMS providers CFUs were similar at sample 1 and 2 (p=0.2, 0.2, respectively). Before a shift, 100 samples harbored CIPs (19 MRSA, 66 MSSA, 15 VRE). Following the shift, 88 new CIPs were recovered (24 MRSA, 53 MSSA, 11 VRE). At Sample 1, 59 (59%) of CIPs were harbored on EMS uniforms, and 41 in ambulances. At Sample 3, 62 (70%) of CIPs were harbored on EMS uniforms. Other results can be seen in Table 2. Table 2.Median CFUs for Emergency and Transport Ambulances and EMS Providers by Sample, and Number of CIPs Recovered Conclusion Our data demonstrate provider uniforms were contaminated upon arrival and ambulances were contaminated when deemed ready for service. Further studies are needed to determine optimal disinfection procedures of ambulances and EMS uniforms. Disclosures All Authors: No reported disclosures.