Major Article
Bacterial contamination of health care workers' white coats

https://doi.org/10.1016/j.ajic.2008.03.009Get rights and content

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.

Section snippets

Study population

We conducted a cross-sectional study at the University of Maryland Medical Center in Baltimore, Maryland, an inner-city tertiary care hospital with 669 beds.16 In previous studies, this facility was found to have a colonization prevalence of 25% S aureus, 7% MRSA, and 5.2% VRE among recently admitted non-ICU patients, as well as a colonization prevalence of 7.2% MRSA, 10.1% VRE, and 2.7% co-colonized with MRSA and VRE among recently admitted medical and surgical ICU patients.17, 18 The medical

Results

Among the 149 participants who were wearing their white coats at study entry, 109 attended medical grand rounds and 40 attended surgical grand rounds. Table 1 shows the frequency of participants contaminated with S aureus isolates based on the demographic data and laundering habits. Overall, 22.8% (95% CI = 16.1% to 29.6%) were contaminated with S aureus and 4% (95% CI = 0.8% to 7.1%) were contaminated with MRSA. Twenty-nine white coats of the internal medicine participants (26.6%; 95% CI =

Discussion

Our data suggest that health care workers' white coats frequently are contaminated with S aureus, and that many of those isolates are methicillin-resistant, contradicting the conclusion of a recent review.15 The data are similar to those from previous evaluations of S aureus but lower than expected for resistant isolates of S aureus and enterococci.9, 10, 11, 12 These numbers also mirror the published rates of S aureus colonization seen in medical and surgical ICU inpatients and non-ICU

References (18)

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