Advertisement

Impact of home versus hospital dressing on bacterial contamination of surgical scrubs in the obstetric setting: A randomized controlled trial

Published:October 19, 2017DOI:https://doi.org/10.1016/j.ajic.2017.09.009

      Highlights

      • The impact of where a physician dresses in their scrubs on total bacterial burden remains unknown.
      • Obstetrics and gynecology resident physicians were randomized to wear scrubs that were put on at home versus at the hospital.
      • There were no differences in total bacterial count between the study arms.

      Background

      The impact of the site where an obstetrician dresses in their surgical scrubs, home versus hospital, on total bacterial burden remains unknown. Therefore, our objective was to quantify the effect of dressing in surgical scrubs at home versus at the hospital on the bacterial contamination at the beginning of a scheduled shift.

      Methods

      This was a single blind randomized controlled trial. Eligible participants were resident physicians assigned to labor and delivery at a single institution during the study period, and participants were randomized daily to 1 of 4 arms based on the site where their scrubs were laundered (A) and where the resident dressed (B) (A/B): home/home, home/hospital, hospital/home, and hospital/hospital. At the beginning of the assigned shift, microbiologic samples from the chest pocket and pants' tie were collected with a sterile culture swab. Samples were plated on trypticase soy agar with 5% sheep blood before being incubated at 35°C-37°C for 48 hours, with observation every 24 hours. The primary outcome was total bacterial burden, defined as the sum of the colony forming units (CFUs) from the 2 sampling sites.

      Results

      There were 21 residents randomized daily for 4 days to 1 of 4 study arms, resulting in 84 observations. There were no baseline differences between the home- and hospital-dressed cohorts. Overall, 68% of sampled scrubs demonstrated some bacterial growth. There was no difference between the home- and hospital-dressed cohorts in percentage of samples demonstrating any bacterial growth after 72 hours (60% vs 76%, P = .14), nor in median bacterial burden at the beginning of a shift (2 [interquartile range, 0-7] vs 1 [interquartile range, 1-5] CFUs, P = .62). Finally, there was no difference in total bacterial burden at the beginning of a shift between the home- and hospital-dressed cohorts when stratified by site where the scrubs were laundered.

      Conclusions

      There was no significant difference in total bacterial burden of surgical scrubs at the start of a shift between cohorts who dressed at home versus at the hospital.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Schulster L.M.
        • Chinn R.Y.W.
        • Arduino M.J.
        • Carpenter J.
        • Donlan R.
        • Ashford D.
        • et al.
        Guidelines for environmental infection control in health-care facilities. Recommendations from CDC and the healthcare infection control practices advisory committee (HICPAC).
        American Society for Healthcare Engineering/American Hospital Association, Chicago (IL)2004
        • Mangram A.J.
        • Horan T.C.
        • Pearson M.L.
        • Silver L.C.
        • Jarvis W.R.
        Guideline for prevention of surgical site infection, 1999. Hospital infection control practices advisory committee.
        Infect Control Hosp Epidemiol. 1999; 20: 247-278
        • Braswell M.L.
        • Spruce L.
        Implementing AORN recommended practices for surgical attire.
        AORN J. 2012; 95: 122-137
        • Krueger C.A.
        • Murray C.K.
        • Mende K.
        • Guymon C.H.
        • Gerlinger T.L.
        The bacterial contamination of surgical scrubs.
        Am J Orthop. 2012; 41: E69-E73
        • Munoz-Price L.S.
        • Arheart K.L.
        • Lubarsky D.A.
        • Birnbach D.J.
        Differential laundering practices of white coats and scrubs among health care professionals.
        Am J Infect Control. 2013; 41: 565-567
        • Nordstrom J.M.
        • Reynolds K.A.
        • Gerba C.P.
        Comparison of bacteria on new, disposable, laundered and unlaundered hospital scrubs.
        Am J Infect Control. 2012; 40: 539-543
        • Burden M.
        • Cervantes L.
        • Weed D.
        • Keniston A.
        • Price C.S.
        • Albert R.K.
        Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8-hour workday: a randomized controlled trial.
        J Hosp Med. 2011; 6: 177-182
        • Sanon M.A.
        • Watkins S.
        Nurses' uniforms: how many bacteria do they carry after one shift?.
        J Public Health Epidemiol. 2012; 4: 311-315
        • Munoz-Price L.S.
        • Arheart K.L.
        • Mills J.P.
        • Cleary T.
        • Depascale D.
        • Jimenez A.
        • et al.
        Associations between bacterial contamination of health care workers' hands and contamination of white coats and scrubs.
        Am J Infect Control. 2012; 40: e245-e248
        • Babb J.R.
        • Davies J.G.
        • Ayliffe G.A.
        Contamination of protective clothing and nurses' uniforms in an isolation ward.
        J Hosp Infect. 1983; 4: 149-157
        • Perry C.
        • Marshall R.
        • Jones E.
        Bacterial contamination of uniforms.
        J Hosp Infect. 2001; 48: 238-241
        • Callaghan I.
        Bacterial contamination of nurses' uniforms: a study.
        Nurs Stand. 1998; 13: 37-42