Emergency medical services oxygen equipment: a fomite for transmission of MRSA?

• Published in: Emergency medicine journal : EMJ Vol. 36; no. 2; pp. 89 - 91
• Main Author: Gibson, Cody Vaughn
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.02.2019
• Subjects: Alabama; Ambulances - organization & administration; Ambulances - statistics & numerical data; Blood pressure; Disinfection & disinfectants; Emergency medical care; Emergency Medical Services - methods; Emergency Medical Services - standards; Emergency services; Equipment and Supplies - microbiology; Equipment and Supplies - standards; Equipment Contamination; Humans; Medical equipment; Methicillin-Resistant Staphylococcus aureus - pathogenicity; Monitoring systems; Oxygen - therapeutic use; Oxygen Inhalation Therapy - adverse effects; Oxygen Inhalation Therapy - methods; Staphylococcus infections; Alabama; Chicago Illinois; United States > US; Maine; bacterial; paramedics; prehospital care; infectious diseases; first responders
• ISSN: 1472-0205; 1472-0213
• DOI: 10.1136/emermed-2018-207758

ObjectivesThe primary purpose of this study was to determine if methicillin-resistant Staphylococcus aureus (MRSA) was present on the surface of oxygen cylinders and regulators used in the prehospital setting and secondarily to assess other surfaces for MRSA within the ambulance compartment, as a comparison.MethodsOn 17 March 2018, the surface of oxygen cylinders and regulators located in ambulances at an emergency medical services (EMS) station in North Alabama (n=9) and at an offsite oxygen cylinder storage area (n=70) were swabbed using sterile cotton-tipped applicators saturated in an 0.9% NaCl solution. These cotton-tipped applicators were then streaked across the surface of HardyCHROM MRSA plates, followed by incubation at 36°C for 24 hours. The growth of pink or magenta colonies was considered a positive indication for the presence of MRSA. The motivation for assessing oxygen cylinders at the offsite storage area was to outline the persistence of MRSA on stored oxygen cylinders.ResultsOf nine oxygen cylinders tested in the ambulances, nine had MRSA colonisation (100%). MRSA was also present on 67 of 70 oxygen cylinders (96%) tested at the offsite oxygen cylinder storage area.ConclusionOxygen cylinders appear to act as a fomite for MRSA. The development of universal disinfection protocols for oxygen equipment could help reduce the risk of patient infection due to cross-contamination.