J Prev Med Public Health.  2012 May;45(3):174-180. 10.3961/jpmph.2012.45.3.174.

Prevalence of Positive Carriage of Tuberculosis, Methicillin-resistant Staphylococcus aureus, and Vancomycin-resistant Enterococci in Patients Transported by Ambulance: A Single Center Observational Study

• Ro YS
• Shin SD
• Noh H
• Cho SI

• KMID: 1381364
• DOI: http://doi.org/10.3961/jpmph.2012.45.3.174

Abstract

OBJECTIVES
An ambulance can be a potential source of contagious or droplet infection of a community. We estimated the prevalence of positive carriage of tuberculosis (TB), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococci (VRE) in patients transported by ambulance.
METHODS
This was a retrospective observational study. We enrolled all patients who visited a tertiary teaching hospital emergency department (ED). Blood, sputum, urine, body fluid, and rectal swab samples were taken from patients when they were suspected of TB, MRSA, or VRE in the ED. The patients were categorized into three groups: pre-hospital ambulance (PA) group; inter-facility ambulance (IA) group; and non-ambulance (NA) group. Adjusted odds ratio (OR) and 95% confidence intervals (CI) were calculated using a multivariable logistic regression model for the prevalence of each infection.
RESULTS
The total number of patients was 89206. Of these, 9378 (10.5%) and 4799 (5.4%) were in the PA and IA group, respectively. The prevalence of TB, MRSA, and VRE infection were 0.3%, 1.1%, and 0.3%, respectively. In the PA group, the prevalence of TB, MRSA, and VRE were 0.3%, 1.8%, and 0.4%. In the IA group, the prevalence of TB, MRSA, and VRE were 0.7%, 4.6%, and 1.5%, respectively. The adjusted ORs (95% CI) of the PA and IA compared to the NA group were 1.02 (0.69 to 1.53) and 1.83 (1.24 to 2.71) for TB, 2.24 (1.87 to 2.69) and 5.47 (4.63 to 6.46) for MRSA, 2.59 (1.78 to 3.77) and 8.90 (6.52 to 12.14) for VRE, respectively.
CONCLUSIONS
A high prevalence of positive carriage of TB, MRSA, and VRE in patients transported by metropolitan ambulances was found.

Keyword

Prevalence; Infection; Tuberculosis; Resistance; Emergency medical services

MeSH Terms

Adolescent
Adult
Aged
*Ambulances
Anti-Bacterial Agents/*therapeutic use
Enterococcus/*drug effects
Female
Humans
Male
Methicillin-Resistant Staphylococcus aureus/*drug effects
Middle Aged
Prevalence
Republic of Korea/epidemiology
Retrospective Studies
Staphylococcal Infections/*epidemiology
*Transportation of Patients
Tuberculosis/diagnosis/*epidemiology
Vancomycin/*therapeutic use
Vancomycin Resistance/*drug effects
Young Adult