Abstract
Background: Healthcare associated infections (HCAIs) are a global threat, specifically in low- and middle-income countries. There is also evidence to suggest that contamination of a range of equipment used in pre-hospital emergency care may constitute a significant risk for HCAIs. Several studies have identified contamination of equipment used for pre-hospital emergency care with a wide range of bacterial and other pathogens; however, most of these studies have been done in other countries and in emergency medical services (EMS) systems with characteristics quite different to those encountered in South Africa. Countries in which these studies have been done also have a quite different burden of disease, and specifically a much lower incidence of infectious diseases as a cause of mortality compared to that in South Africa. Although there is a very broad range of pre-hospital emergency care equipment that could possibly become contaminated with bacterial pathogens during routine patient care, pulmonary infection may be caused by instrumentation used in the airway during pre-hospital ETI, which makes investigation of airway and ventilation equipment contamination a pertinent starting point. The aim of this research was to describe and determine the prevalence of bacterial contamination of airway management and ventilation equipment used in a South African pre-hospital environment and to describe current approaches to cleaning, decontamination or sterilization of this equipment. Methods: A prospective, quantitative, descriptive, cross-sectional research design was used for this study. A selection of airway management and ventilation equipment from one private and one public EMS, and one private Helicopter EMS (HEMS) in Gauteng was included in the study. Items of equipment, in a state of operational readiness, were swabbed and the swabs were transported under controlled conditions where they were analysed in a laboratory for the presence of bacterial organisms and their antimicrobial resistance. Simultaneous with sampling from the equipment, a survey questionnaire designed to investigate knowledge and current infection prevention practises related to this equipment was administered to advanced life support (ALS) emergency care personnel using this equipment. Data analysis was descriptive in nature – for the bacterial isolates, this involved simply listing the organisms identified and their antimicrobial resistance...
M.Cur.