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Bacterial contamination of health care workers' white coats.
Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA.
BACKGROUND: Patient-to-patient transmission of nosocomial pathogens has been linked to transient colonization of health care workers, and studies have suggested that contamination of health care workers' clothing, including white coats, may be a vector for this transmission. METHODS: We performed a cross-sectional study involving attendees of medical and surgical grand rounds at a large teaching hospital to investigate the prevalence of contamination of white coats with important nosocomial pathogens, such as methicillin-sensitive Stapylococcus aureus, methicillin-resistant S aureus (MRSA), and vancomycin-resistant enterococci (VRE). Each participant completed a brief survey and cultured his or her white coat using a moistened culture swab on lapels, pockets, and cuffs. RESULTS: Among the 149 grand rounds attendees' white coats, 34 (23%) were contaminated with S aureus, of which 6 (18%) were MRSA. None of the coats was contaminated with VRE. S aureus contamination was more prevalent in residents, those working in inpatient settings, and those who saw an inpatient that day. CONCLUSION: This study suggests that a large proportion of health care workers' white coats may be contaminated with S aureus, including MRSA. White coats may be an important vector for patient-to-patient transmission of S aureus
Infect Control Hosp Epidemiol. 2008 Jul;29(7):583-9.
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Detection of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on the gowns and gloves of healthcare workers.
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
OBJECTIVE: To assess the rate of and the risk factors for the detection of methicillin-resistant S. aureus (MRSA) and vancomycin-resistant enterococci (VRE) on the protective gowns and gloves of healthcare workers (HCWs). METHODS: We observed the interactions between HCWs and patients during routine clinical activities in a 29-bed medical intensive care unit at the University of Maryland Medical Center, an urban tertiary care academic hospital. Samples for culture were obtained from HCWs' hands prior to their entering a patient's room, from HCWs' disposable gowns and gloves after they completed patient care activities, and from HCWs' hands immediately after they removed their protective gowns and gloves. RESULTS: Of 137 HCWs caring for patients colonized or infected with MRSA and/or VRE, 24 (17..5%; 95% confidence interval, 11.6%-24.4%) acquired the organism on their gloves, gown, or both. HCW contact with the endotracheal tube or tracheostomy site of a patient (P < .05), HCW contact with the head and/or neck of a patient (P < .05), and HCW presence in the room of a patient with a percutaneous endoscopic gastrostomy and/or jejunostomy tube (P < .05) were associated with an increased risk of acquiring these organisms.. CONCLUSIONS: The gloves and gowns of HCWs frequently become contaminated with MRSA and VRE during the routine care of patients, and particularly during care of the patient's respiratory tract and any associated indwelling devices. As part of a larger infection control strategy, including high-compliance hand disinfection, they likely provide a useful barrier to transmitting antibiotic-resistant organisms among patients in an inpatient setting.
Best,Paul AlexanderStudent in EBHC Oxford
--- On Mon, 5/11/09, Dr. Carlos Cuello <[log in to unmask]> wrote:
From: Dr. Carlos Cuello <[log in to unmask]>
Subject: tie and influenzaReceived: Monday, May 11, 2009, 3:20 PM
A recent recommendation in Mexico is that all health secretary and gubernamental workers must lose their ties. This will be obviously a tragedy for the economic of the companies that sell them and the bow tie might be back (which I personally don´t dislike).
I tried to search evidence on the topic, specifically clinical data that could be evidence for or against the use of ties with clinical outcomes. I did not find anything on Pubmed using the search strategy "(white coat OR tie) AND infection"
Any suggestions? evidence? even if it is indirect evidence
--
Carlos A. Cuello-García, MD
Director, Centre for Evidence-Based Practice-Tecnologico de Monterrey
Cochrane-ITESM coordinator. Professor of Paediatrics and Clinical Research
Avda. Morones Prieto 3000 pte. Col. Doctores. CITES 3er. piso,Monterrey NL, México. CP64710
Phone. +52(81)88882154 & 2141. Fax: +52(81)88882019
www.cmbe.net
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