H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal; NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Portugal; Comprehensive Health Research Center (CHRC), Portugal.
H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
Environ Res. 2021 Jun;197:111125. doi: 10.1016/j.envres.2021.111125. Epub 2021 Apr 22.
Ambulance vehicles are an essential part of emergency clinical services. Bioburden control in ambulances, through cleaning and disinfection, is crucial to minimize hospital-acquired infections, cross contamination and exposure of patients and ambulances' crew. In Portugal, firefighter crews are responsible, besides fire extinction, for first aid and urgent pre-hospital treatment. This study assessed the bioburden in Portuguese firefighters' ambulances with a multi-approach protocol using active and passive sampling methods. Fungal resistance profile and mycotoxins detection in ambulances' ambient, and S. aureus (SA) prevalence and resistance profile in ambulances' ambient and colonization in workers were also investigated. Toxigenic fungi with clinical relevance, namely Aspergillus section Fumigati, were found on ambulance's air in the hazardous dimension range. Interestingly, surface contamination was higher after cleaning in several sampling sites. Prevalence of S. aureus was 3% in environmental samples, of which 2% were methicillin-sensitive (MSSA) and 1% methicillin-resistant (MRSA). About 2.07 fungal species were able to grow in at least one azole, ranging from one (44% samples) to five (6% samples) species in each azole. Mycotoxins were detected in mops and electrostatic dust cloths. Colonization by S. aureus in the firefighter crew was observed with a high associated prevalence, namely 48%, with a 24% prevalence of MSSA (8/33) and 21% of MRSA (7/33). Additional studies are needed to determine the potential risk of infection transmission between different vehicle fleets and under varying conditions of use. This will strengthen the paramedic sector's mission to save lives without putting their own health and safety at risk.
救护车是紧急临床服务的重要组成部分。通过清洁和消毒来控制救护车中的生物负荷对于最大限度地减少医院获得性感染、交叉污染以及患者和救护车工作人员的暴露至关重要。在葡萄牙，消防员除了灭火外，还负责急救和紧急院前治疗。本研究使用主动和被动采样方法的多方法方案评估了葡萄牙消防员救护车中的生物负荷。还研究了救护车环境中的真菌耐药谱和霉菌毒素检测，以及救护车环境中的金黄色葡萄球菌（SA）流行率和耐药谱以及工作人员的定植情况。具有临床相关性的产毒真菌，即烟曲霉组，在救护车的空气中处于危险维度范围内。有趣的是，在几个采样点清洁后，表面污染更高。环境样本中金黄色葡萄球菌的流行率为 3%，其中 2%为甲氧西林敏感（MSSA），1%为耐甲氧西林（MRSA）。至少有一种唑类药物能够在至少一种唑类药物中生长的真菌种类约为 2.07 种，每种唑类药物中从一种（44%的样本）到五种（6%的样本）不等。在拖把和静电除尘布中检测到霉菌毒素。在消防员机组中观察到金黄色葡萄球菌定植率很高，为 48%，其中 MSSA（8/33）的流行率为 24%，MRSA（7/33）的流行率为 21%。需要进行更多的研究来确定不同车队之间以及在不同使用条件下感染传播的潜在风险。这将加强护理人员的使命，即在不危及自身健康和安全的情况下拯救生命。
