Time to Hang Up the White Coat? Epidemiologists Suggest Ways to Prevent Clothing From Spreading Infection

Kuehn, Bridget M.

doi:10.1001/jama.2014.794

Cited by 11 publications

(11 citation statements)

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“…At the same time, the bitter irony is white coats are also known to harbor pathogenic bacteria transiently, thus transmitting the microbes in the hospital environment and also predispose to the patients-to-patients transmission of infections [ 7 , 8 ]. Although studies have not directly linked healthcare workers' apparel to HAIs, different research groups have found that white coats are often colonized with pathogenic bacteria including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) [ 9 , 10 ]. Among the health workers, nurses are the ones who come in direct contact with the patients during treatment and care.…”

Section: Introductionmentioning

confidence: 99%

Bacteria on Medical Professionals’ White Coats in a University Hospital

Mishra

Maharjan

Yadav³

et al. 2020

Canadian Journal of Infectious Diseases and Medical Microbiolog

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The transient contamination of medical professional’s attires including white coats is one of the major vehicles for the horizontal transmission of microorganisms in the hospital environment. This study was carried out to determine the degree of contamination by bacterial agents on the white coats in a tertiary care hospital in Nepal. Sterilized uniforms with fabric patches of 10 cm × 15 cm size attached to the right and left pockets were distributed to 12 nurses of six different wards of a teaching hospital at the beginning of their work shift. Worn coats were collected at the end of the shifts and the patches were subjected for total bacterial count and identification of selected bacterial pathogens, as prioritized by the World Health Organization (WHO). Fifty percent of the sampled swatches were found to be contaminated by pathogenic bacteria. The average colony growth per square inch of the patch was 524 and 857 during first and second workdays, respectively, indicating an increase of 63.6% in colony counts. The pathogens detected on patches were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter sp. Additional bacteria identified included Bacillus sp., Micrococcus sp., and coagulase-negative staphylococci (CoNS). The nurses working in the maternity department had their white coats highly contaminated with bacteria. On the other hand, the least bacterial contamination was recorded from the nurses of the surgery ward. One S. aureus isolate from the maternity ward was resistant to methicillin. This study showed that pathogens belonging to the WHO list of critical priority and high priority have been isolated from white coats of nurses, thus posing the risk of transmission to patients. White coats must be worn, maintained, and washed properly to reduce bacterial contamination load and to prevent cross-contamination of potential superbugs. The practice of wearing white coats outside the healthcare zone should be strictly discouraged.

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Section: Introductionmentioning

confidence: 99%

Bacteria on Medical Professionals’ White Coats in a University Hospital

Mishra

Maharjan

Yadav³

et al. 2020

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…10 Nevertheless, organizations concerned with infection control, such as the Society for Healthcare Epidemiology of America, recommend taking cautious measures, including removing white coats during patient examination or direct patient contact. 14 As the potential risk of HAI transmission through white coats needs to be further evaluated, there is no clear policy regarding white coat wearing in most healthcare settings. The purpose of this review was to critically examine the evidence on the potential role of white coat contamination in horizontal microbial transmission and HAIs risk to help inform HCW attire policies.…”

mentioning

confidence: 99%

What’s Up Your Sleeve? A Scoping Review of White Coat Contamination and Horizontal Microbial Transmission

Sajdeya¹,

Wijayabahu²,

Stetten³

et al. 2022

Southern Medical Journal

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Objectives: White coats have been suggested to serve as fomites carrying and transmitting pathogenic organisms and potentially increasing the risk of healthcare-associated infections (HAIs). We aimed to examine the current evidence regarding white coat contamination and its role in horizontal transmission and HAIs risk. We also examined handling practices and policies associated with white coat contamination in the reviewed literature.Methods: We conducted a literature search through PubMed and Web of Science Core Collection/Cited Reference Search, and manually searched the bibliographies of the articles identified in electronic searches. Studies published up to March 3, 2021 that were accessible in English-language full-text format were included.Results: Among 18 included studies, 15 (83%) had ≥100 participants, 16 (89%) were cross-sectional studies, and 13 (72%) originated outside of the United States. All of the studies showed evidence of microbial colonization. Colonization with Staphylococcus aureus and Escherichia coli was reported in 100% and 44% of the studies, respectively. Antibacterialresistant strains, including methicillin-resistant Staphylococcus aureus and multidrug-resistant organisms were reported in 8 (44%) studies. There was a lack of studies assessing the link between white coat contamination and HAIs. The data regarding white coat handling and laundering practices showed inconsistencies between healthcare facilities and a lack of clear policies.Conclusions: There is robust evidence that white coats serve as fomites, carrying dangerous pathogens, including multidrug-resistant organisms. A knowledge gap exists, however, regarding the role of contaminated white coats in HAI risk that warrants further research to generate the evidence necessary to guide the current attire policies for healthcare workers.

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“…10,11 Thus, it is currently recommended that in addition to hand hygiene, hospital uniforms be changed daily, regardless of their appearance (eg, soiled or unsoiled). 12,13 However, many healthcare workers do not adhere to this recommendation, increasing the risk of nosocomial infections. 14 The abundance of infectious contaminants on hospital textiles has frequently been assessed on physicians' white coats.…”

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confidence: 99%

Comparing colony-forming units in inpatient nurses: Should military nurses who provide patient care wear hospital-provided scrubs?

West

Resendiz

Lustik

et al. 2018

Infect. Control Hosp. Epidemiol.

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Nurses should be aware that bacteria are present at much higher levels on their personal military uniforms compared to hospital-provided scrubs. Additional research is needed to determine whether these findings are a function of wear, laundering, or environmental factors. Nurses should adhere to daily uniform washing to reduce bacterial load and minimize risk of nosocomial infections to the patients they care for.

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Time to Hang Up the White Coat? Epidemiologists Suggest Ways to Prevent Clothing From Spreading Infection

Cited by 11 publications

References 0 publications

Bacteria on Medical Professionals’ White Coats in a University Hospital

Bacteria on Medical Professionals’ White Coats in a University Hospital

What’s Up Your Sleeve? A Scoping Review of White Coat Contamination and Horizontal Microbial Transmission

Comparing colony-forming units in inpatient nurses: Should military nurses who provide patient care wear hospital-provided scrubs?

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