{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:53:26Z","timestamp":1785884006001,"version":"3.56.0"},"reference-count":19,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T00:00:00Z","timestamp":1626825600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X21002725_as1\"><jats:title>Objective:<\/jats:title><jats:p>To estimate the relative risk (RR) of developing methicillin-resistant<jats:italic>Staphylococcus aureus<\/jats:italic>(MRSA) or vancomycin-resistant<jats:italic>Enterococcus<\/jats:italic>(VRE) colonization or infection within 30 days of ambulance transport.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21002725_as2\"><jats:title>Methods:<\/jats:title><jats:p>We performed a retrospective cohort study of patients with a principal diagnosis of chest pain presenting to our emergency department (ED) over a 4-year period. Patients were included if they presented from and were discharged to nonhealthcare locations without being admitted. Encounters were stratified by arrival mechanism: ambulance versus private vehicle. We performed propensity score matching and multivariable logistic regression to estimate the RR for the primary outcome.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21002725_as3\"><jats:title>Results:<\/jats:title><jats:p>In total, 321,229 patients had ED encounters during the study period. After applying inclusion criteria and propensity score matching, there were 11,324 patients: 3,903 in the ambulance group and 7,421 in the unexposed group. Among them, 12 patients (0.11%) had the outcome of interest, including 9 (0.08%) with MRSA and 3 (0.03%) with VRE. The 30-day prevalence of MRSA or VRE was larger in the ambulance group than in the unexposed group: 8 (0.20%) and 4 (0.05%), respectively (<jats:italic>P<\/jats:italic>= .02). Patients who presented to the ED via ambulance were almost 4 times more likely to have MRSA or VRE within 30 days of their encounter (RR, 3.72; 95% CI, 1.09\u201312.71;<jats:italic>P<\/jats:italic>= .04).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X21002725_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>Our cohort study is the first to demonstrate an association between ambulance exposure and pathogen incidence, representing the first step in evaluating medical-transport\u2013associated infection burden to eventually develop interventions to address it.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2021.272","type":"journal-article","created":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T07:33:22Z","timestamp":1626852802000},"page":"442-447","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["Risk of methicillin-resistant<i>Staphylococcus aureus<\/i>(MRSA) and vancomycin-resistant<i>Enterococcus<\/i>(VRE) acquisition during ambulance transport: A retrospective propensity-score\u2013matched cohort analysis"],"prefix":"10.1017","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5702-9347","authenticated-orcid":false,"given":"Diego","family":"Schaps","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew W.","family":"Godfrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deverick J.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,7,21]]},"reference":[{"key":"S0899823X21002725_ref13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.13480"},{"key":"S0899823X21002725_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/9781118548387"},{"key":"S0899823X21002725_ref1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.1354"},{"key":"S0899823X21002725_ref8","doi-asserted-by":"publisher","DOI":"10.1097\/MEJ.0b013e328357938e"},{"key":"S0899823X21002725_ref5","doi-asserted-by":"publisher","DOI":"10.3109\/10903127.2014.967427"},{"key":"S0899823X21002725_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2019.108"},{"key":"S0899823X21002725_ref17","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X13003476"},{"key":"S0899823X21002725_ref14","doi-asserted-by":"publisher","DOI":"10.1214\/09-STS313"},{"key":"S0899823X21002725_ref16","doi-asserted-by":"publisher","DOI":"10.3109\/10903127.2015.1076098"},{"key":"S0899823X21002725_ref7","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2018-207872"},{"key":"S0899823X21002725_ref2","doi-asserted-by":"publisher","DOI":"10.3109\/10903127.2013.851311"},{"key":"S0899823X21002725_ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s40168-017-0339-6"},{"key":"S0899823X21002725_ref19","doi-asserted-by":"publisher","DOI":"10.3961\/jpmph.2012.45.3.174"},{"key":"S0899823X21002725_ref10","unstructured":"10. Rui, P , Kang, K. National Hospital Ambulatory Medical Care Survey: 2017 emergency department summary tables, in National Center for Health Statistics Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/nchs\/data\/nhamcs\/web_tables\/2017_ed_web_tables-508.pdf. Published 2017. Accessed June 16, 2021."},{"key":"S0899823X21002725_ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-018-0541-y"},{"key":"S0899823X21002725_ref11","volume-title":"An Introduction to Medical Statistics,","author":"Bland","year":"2015"},{"key":"S0899823X21002725_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2009.07.020"},{"key":"S0899823X21002725_ref18","doi-asserted-by":"publisher","DOI":"10.3109\/10903127.2012.717169"},{"key":"S0899823X21002725_ref3","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1136\/emermed-2018-207758","article-title":"Emergency medical services oxygen equipment: a fomite for transmission of MRSA?","volume":"36","author":"Gibson","year":"2019","journal-title":"Emerg Med J"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X21002725","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T17:37:06Z","timestamp":1725471426000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X21002725\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,21]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["S0899823X21002725"],"URL":"https:\/\/doi.org\/10.1017\/ice.2021.272","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,21]]},"assertion":[{"value":"\u00a9 The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}