Nurses’ Uniforms Often Contain Dangerous Bacteria

TON - October 2011 Vol 4 No 7 — October 19, 2011

Many oncology nurses may be wearing uniforms that contain harmful bacteria, including drug-resistant organisms. A new study has found that more than 60% of hospital staff’s uniforms are colonized with potentially pathogenic bacteria. The study, which was published in the September issue of the American Journal of Infection Control (Wiener-Well Y, et al. 2011;39:555-559), suggests that physicians and nurses may be transferring pathogens that could cause clinically relevant infection.

The investigators isolated antibioticresistant bacteria from samples from 14% of nurses’ uniforms and 6% of physicians’ uniforms in a single institution. A total of 135 nurses and physicians from the medical and surgical wings were included in the study.

“The study was well done and found some interesting results,” said Russell Olmsted, MPH, president of the Association for Professionals in Infection Control and Epidemiology. “The study is of interest to oncology nurses in that we have pathogens that cause healthcare-associated infection on a wide range of surfaces, and this study is a reminder that they have to have good hand hygiene.”

He said this study points to ways nurses may be able to lower their risk of inadvertently transferring pathogens to patients. “Because it shows articles we touch certainly can result in contamination of our hands. The hands are the mode or mechanism to get the pathogen to patients,” Olmsted said in an interview with The Oncology Nurse-APN/PA.

In recent years, studies have shown physicians’ white coats and ties, medical students’ coats, and nurses’ uniforms have been colonized with pathogenic organisms and could be potential sources of cross-infection. It is believed that the greatest amount of contamination may occur in areas of greatest hand contact, such as pockets and cuffs, allowing recontamination of already washed hands. In the current study, researchers at the Shaare Zedek Medical Center in Jerusalem, Israel, collected swab samples from 3 parts of the uniforms of 75 registered nurses (RNs) and 60 medical doctors (MDs) by pressing standard blood agar plates at the abdominal zone, sleeves’ ends, and pockets.

The researchers found that half of all the cultures taken (65% of the RN uniforms and 60% of the MD uniforms) harbored pathogens. Of those, 21 cultures from RN uniforms and 6 cultures from MD uniforms contained multidrug- resistant pathogens, including 8 cultures that grew methicillin-resistant Staph y lococcus aureus. Although the uniforms themselves may not pose a direct risk of disease transmission, these results indicate a prevalence of antibiotic-resistant strains in close proximity to hospitalized patients.

The study was conducted at a 550- bed, university-affiliated hospital. It is unknown how widely applicable these findings are to community hospitals and cancer centers in the United States. Olmsted noted that any clothing that is worn by humans will become contaminated with microorganisms. According to the World Health Organization, the risk of healthcare-associated infection (HAI) in some developing countries is as much as 20 times higher than in developed countries. Even in hospitals in developed countries such as the United States, HAIs occur too often, can be deadly, and are expensive to treat.

A previous study conducted at a burn unit demonstrated the possibility of transferring S aureus from nurses’ gowns to patients and bed sheets. In this current study, researchers say the high prevalence of contaminated uniforms may be related to inadequate compliance with hand hygiene. However, that still needs to be further studied. Overall, they found no significant differences between nurses and physicians or between staff from medical departments and surgical departments.

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