Major Article| Volume 37, ISSUE 2, P101-105, March 2009

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Bacterial contamination of health care workers' white coats


      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.


      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.


      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.


      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.
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        • Cosgrove S.E.
        • Sakoulas G.
        • Perencevich E.N.
        • Schwaber M.J.
        • Karchmer A.W.
        • Carmeli Y.
        Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis.
        Clin Infect Dis. 2003; 36: 53-59
        • Stosor V.
        • Peterson L.R.
        • Postelnick M.
        • Noskin G.A.
        Enterococcus faecium bacteremia: does vancomycin resistance make a difference?.
        Arch Intern Med. 1998; 158: 522-527
        • Pelz R.K.
        • Lipsett P.A.
        • Swobda S.M.
        • Diener-West M.
        • Powe N.R.
        • Brower R.G.
        • et al.
        Vancomycin-sensitive and vancomycin-resistant enterococcal infections in the ICU: attributable costs and outcomes.
        Intensive Care Med. 2002; 23: 692-697
        • DiazGranados C.A.
        • Zimmer S.M.
        • Klein M.
        • Jernigan J.A.
        Comparison of mortality associated with vancomycin-resisitant and vancomycin-susceptible enterococcal bloodstream infections: a meta-analysis.
        Clin Infect Dis. 2005; 41: 327-333
        • Zachary K.C.
        • Bayne P.S.
        • Morrison V.J.
        • Ford D.S.
        • Silver L.C.
        • Hooper D.C.
        Contamination of gowns, gloves, and stethoscopes with vancomycin-resistant enterococci.
        Infect Control Hosp Epidemiol. 2001; 22: 560-564
        • Smith M.A.
        • Mathewson J.J.
        • Ulert I.A.
        • Scerpella E.G.
        • Ericsson C.D.
        Contaminated stethoscopes revisited.
        Arch Intern Med. 1996; 156: 82-84
        • Lankford M.G.
        • Collins S.
        • Youngberg L.
        • Rooney D.M.
        • Warren J.R.
        • Noskin G.A.
        Assessment of materials commonly utilized in health care: implications for bacterial survival and transmission.
        Am J Infect Control. 2006; 24: 258-263
        • Hardy K.J.
        • Oppenheim B.A.
        • Gossain S.
        • Gao F.
        • Hawkey P.M.
        A study of the relationship between environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) and patients' acquisition of MRSA.
        Infect Control Hosp Epidemiol. 2006; 27: 127-132
        • Wong D.
        • Nye K.
        • Hollis P.
        Microbial flora on doctors' white coats.
        BMJ. 1991; 303: 1602-1604
        • Loh W.
        • Ng V.V.
        • Holton J.
        Bacterial flora on the white coats of medical students.
        J Hosp Infect. 2000; 45: 65-68
        • Perry C.
        • Marshall R.
        • Jones E.
        Bacterial contamination of uniforms.
        J Hosp Infect. 2001; 48: 238-241
        • Osawa K.
        • Baba C.
        • Ishimoto T.
        • Chiada T.
        • Okamura N.
        • Miyake S.
        • et al.
        Significance of a methicillin-resistant Staphylococcus aureus (MRSA) survey in a university teaching hospital.
        J Infect Chemother. 2003; 9: 172-177
      1. Government News Network. Johnson outlines new measures to tackle hospital bugs. Available from: Accessed March 25, 2008.

        • Pratt R.J.
        • Pellowe C.M.
        • Wilson J.A.
        • Loveday H.P.
        • Harper P.J.
        • Jones S.R.
        • et al.
        epic2: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England.
        J Hosp Infect. 2007; 65: S1-S64
        • Wilson J.A.
        • Loveday H.P.
        • Hoffman P.N.
        • Pratt R.J.
        Uniform: an evidence review of the microbiological significance of uniforms and uniform policy in the prevention and control of healthcare-associated infections. Report to the Department of Health (England).
        J Hosp Infect. 2007; 66: 301-307
      2. University of Maryland. About the University of Maryland Medical Center. Available from: Accessed November 21, 2007.

        • Furuno J.P.
        • McGregor J.C.
        • Harris A.D.
        • Johnson J.A.
        • Johnson J.K.
        • Langenberg P.
        • et al.
        Identifying groups at high risk for carriage of antibiotic-resistant bacteria.
        Arch Intern Med. 2006; 166: 580-585
        • Furuno J.P.
        • Perencevich E.N.
        • Johnson J.A.
        • Wright M.O.
        • McGregor J.G.
        • Morris Jr., J.G.
        • et al.
        Methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci co-colonization.
        Emerg Infect Dis. 2005; 11: 1539-1544