Community as Source of MRSA Infections Among Patients Admitted via Medical Helicopter Transport

Patients transported via helicopter to a hospital from another healthcare facility are no more likely to test positive for the MRSA infection than those flown into the hospital from an accident site, home or other non-healthcare facility, according to a study conducted by Allegheny General Hospital (AGH) emergency personnel.

The study findings contradict a common assumption that patients admitted to the hospital from another healthcare facility would be more likely to carry methicillin-resistant Staphylococcus aureus (MRSA), says lead author Peter S. Martin, MD, FACEP, emergency medicine physician at AGH.

"The incidence of community-acquired MRSA has been dramatically increasing in healthcare settings, and were seeing it more and more in the emergency department," Martin says. "Knowing how MRSA enters the hospital environment can help us as we work to better manage and prevent this dangerous infection in the clinical setting."

"We are usually able to differentiate between hospital and community strains of MRSA based upon their antibiotic sensitivity profile in addition to commonly observed variations in clinical presentation," says Andrew G. Sahud, chairman of infection prevention at AGH. "Being able to predict the type of infection in the community, based upon this epidemiologic data, helps to guide initial empiric therapy for patients previously felt to be low risk for the development of MRSA infections. This study adds to the body of knowledge on an issue that is of critical importance to healthcare facilities."

"The Incidence of MRSA in Air Medical Transport" authored by Martin, Chadd Nesbitt, MD, PhD, and Karen Bourdon, RN, of AGH, LifeFlight, the medical helicopter service of the West Penn Allegheny Health System, was presented at the April 2010, Critical Care Transport Medicine Conference. The abstract will be published in an upcoming edition of Air Medical Journal.

The study examined the records of 827 patients transported by LifeFlight to AGH from April 10 to Dec. 10, 2007, all of whom were tested for MRSA. Of those transported from another healthcare facility, 5.9 percent tested positive for MRSA, while 6.8 percent of those transported from the scene of an incident tested positive. The difference is not statistically significant.

Martin said the AGH study suggests that the incidence of MRSA, in the prehospital setting, may be as high as in those patients originating from other hospitals. Such information implies that testing a wider spectrum of patients presenting to the emergency department might improve infection prevention efforts.