MRSA in the Firehouse: Are You Safe?

By Mike McEvoy
EMS Editor

We hear a lot about MRSA (methicillin-resistant Staphylococcus aureus) these days, and take extra precautions when treating or transporting patients with known MRSA infections. But could you be at risk from firehouse environmental surface contamination? Apparently so, according to a study published in the June 2011 issue of the American Journal of Infection Control

Researchers in Seattle tested nine environmental surfaces at two unnamed stations and 40 firefighters from 13 stations in the northwestern United States. 1,064 environmental surface samples came from areas known to harbor MRSA: medic trucks, engines, fire gear outer surfaces, garage bays, kitchens, bathrooms, bunkrooms, gyms, and washing machines. In addition to analyzing samples for MRSA, researches also genotyped the specimens to identify the particular strain of MRSA present. Some 4.1% of surfaces were MRSA positive, distributed equally between apparatus/garages and living quarters. All of the nine areas sampled produced positive MRSA cultures (including washing machines). 22.5% of firefighter nasal swabs were MRSA positive (compared to 5-10% in health care workers, <2% general population, 2.5% in previously hospitalized patients, 7.5% in college students, and 6-35% in IV drug users).

Genotyping found multiple instances of the same MRSA strains on fire apparatus, turnout gear and living quarters, suggesting possible transmission of MRSA between these areas. Firefighters were often colonized with the same MRSA strains found in stations and apparatus, suggesting transmission between members and their environment. While most MRSA strains were of a Community Acquired (MRSA-CA) type known to circulate in North America, Healthcare Acquired strains (MRSA-HA) were also isolated in stations. Quite obviously, both Community and Hospital Acquired MRSA contaminate fire station surfaces. This is not surprising as firefighters interact extensively with citizens in the community as well as with hospital personnel, potentially exposing them to both strains.

MRSA is an antibiotic-resistant bacterium associated with some 19,000 deaths each year and many more serious infections. While healthcare acquired (MRSA-HA) infections are on the decline, community acquired (MRSA-CA) infections are increasing. Firefighters, in addition to EMS patient contacts and interactions with health care workers, are at increased MRSA risk from close communal living quarters, frequent skin to skin contact, wounds, and in some instances, shared personal care products. This study clearly illustrates that MRSA is present in the fire service environment and, as the first to genotype samples, also suggests transmission is occurring between firefighters and their environment. Time to smarten up. 

Reference

Roberts MC, Soge OO, No D, Beck NK, and Meschke JS. Isolation and characterization of methicillin-resistant Staphylococcus aureus from fire stations in two northwest fire districts. American Journal of Infection Control, 2011; 39:382-389.

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