A Preliminary Assessment of Contamination of Emergency Service Helicopters with MRSA and Multi-Resistant Staphylococcus aureus

Objective: To detect the presence of methicillin-resistant Staphylococcus aureus (MRSA) and multi-resistant S. aureus (Multi-RSA) in emergency service helicopters. Methods: This proof-of-concept study used a convenience sample of two emergency service helicopters located in different Australian towns. Over a three-month period ending January 31 2015, within each helicopter five areas of perceived high contact were sampled by taking swabs on an approximately weekly basis. The precise occasions varied based on timings of cases and maintenance schedules. Swabs were analysed for the presence of MRSA, Multi-RSA and other bacteria. Results: Presumptive MRSA and other colonies were recovered from each helicopter. Of those presumptive colonies tested, 18.7% were identified as Staphylococcus aureus, 76.0% were other staphylococci (such as S. epidermidis), and 5.3% were other genera of bacteria. Further testing of these colonies detected no MRSA or MultiRSA. Over the period of this study, high total numbers of bacteria were recovered in both helicopters. Typically, the floor of the helicopters had higher counts than the seat belts and the blood pressure cuff containers, whereas the radio and cardiac equipment had comparatively lower counts. Conclusions: Since a total of 94.7% of the colonies tested were identified as Staphylococcus spp. the potential for the existence of MRSA in emergency service helicopters is apparent. Our findings highlight the importance of regular cleaning in emergency service vehicles to promote the reduction of infectious disease transmission. We recommend the implementation of a standard operating procedure for cleaning and disinfection across all emergency service providers, reinforced by appropriate infection control training. For quality control, random intermittent swab testing of selected surfaces within all helicopters is advised. The implications of our findings may assist emergency medical service providers to reduce infectious disease transmission risks, and may help to minimise exposure to pathogenic microorganisms during disaster events including pandemics and bioterrorism. tasking to the sick and injured. The vast coverage of helicopter rescue services has been achieved through a number of public and private enterprises. These range from private charitable organizations sponsored by insurance companies that are contracted by Government departments [3], to privately run, Government-supported (crewing) of helicopter services sponsored heavily by business such as large banks [4]. Government-owned air ambulance services and community-based, privately funded enterprises contracted by state governments or state emergency service departments also provide helicopter operations [5]. [6]. Helicopter services in Australia can respond to as many as 1,200 cases per year for Government tendered operations [3] almost 1,000 operations for Government supported, sponsored services such as Westpac [4], to as low as around 300 cases per year for community based helicopter services [6].