Spread of infectious microbes during emergency medical response
Spread of infectious microbes during emergency medical response
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DOI：
10.1016/j.ajic.2015.02.025
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发表时间：
2015-06-01
影响因子：
4.9
通讯作者：
Reynolds, Kelly A.
中科院分区：
文献类型：
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作者：
Valdez, Melissa K.;Sexton, Jonathan D.;Reynolds, Kelly A.
背景：据我们所知，到目前为止，还没有研究表明在实际的紧急医疗服务(EMS)活动中微生物可能会传播。我们的研究介绍了一种新的方法来识别EMS环境污染的贡献者和制定感染控制策略，使用病原体的噬菌体替代品。方法：使用噬菌体FX174追踪交叉污染并评估当前的消毒做法和应急车辆内的过氧化氢(H_2O_2)擦拭干预。在EMS呼叫之前，2个表面播种了FX174。在呼叫结束时，按照现行做法在去污前、去污后和实施干预措施后对EMS车辆和设备表面进行采样。结果：当前去污做法不能显著降低表面上的病毒载量(P=.3113)，但过氧化氢擦拭干预能显著降低表面病毒载量(P=.0065)。噬菌体扩散到56%(27/48)的地点，在当前的净化措施和干预措施下，分别降至54%(26/48)和40%(19/48)。结论：结果表明，消防员的手是微生物传播的主要媒介。目前的做法没有得到始终如一的应用或标准化，并最大限度地减少了EMS表面微生物污染的流行率和数量。尽管使用一致的双氧水擦拭方案显著降低了病毒的患病率和浓度，但仍应提供表面消毒的培训和推广。由Elsevier Inc.代表感染控制和流行病学专业人员协会出版。
Background: To our knowledge, no studies to date demonstrate potential spread of microbes during actual emergency medical service (EMS) activities. Our study introduces a novel approach to identification of contributors to EMS environment contamination and development of infection control strategies, using a bacteriophage surrogate for pathogenic organisms.Methods: Bacteriophage FX174 was used to trace cross-contamination and evaluate current disinfection practices and a hydrogen peroxide (H2O2) wipe intervention within emergency response vehicles. Prior to EMS calls, 2 surfaces were seeded with FX174. On call completion, EMS vehicle and equipment surfaces were sampled before decontamination, after decontamination per current practices, and after implementation of the intervention.Results: Current decontamination practices did not significantly reduce viral loads on surfaces (P = .3113), but H2O2 wipe intervention did (P = .0065). Bacteriophage spread to 56% (27/48) of sites and was reduced to 54% (26/48) and 40% (19/48) with current decontamination practices and intervention practices, respectively.Conclusion: Results suggest firefighters' hands were the main vehicles of microbial transfer. Current practices were not consistently applied or standardized and minimally reduced prevalence and quantity of microbial contamination on EMS surfaces. Although use of a consistent protocol of H2O2 wipes significantly reduced percent prevalence and concentration of viruses, training and promotion of surface disinfection should be provided. Published by Elsevier Inc. on behalf of the Association for Professionals in Infection Control and Epidemiology, Inc.