Abstract
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.
Highlights
Healthcare-associated infections (HAIs) are the most frequent adverse events in healthcare delivery
From those 12 nurses, 12 fabric patches were sampled after the first-day work shift and an equal number after the second-day work shift. e plate count revealed bacterial contamination of all the fabric patches from the nurses after their first and second work shifts
E average colony count per square inch of the patch was 524 and 857 during the first and second workdays, respectively. e highest degree of average bacterial contamination was seen on fabrics collected from nurses of the maternity ward after the second-day work shift (1942.5 CFU/ inch2), and a significantly lower degree of average bacterial contamination was seen on fabric patches collected from the surgery ward after the first-day work shift (103.5 CFU/ inch2). e degree of bacterial contamination increased on all the sampled patches collected after the second shift as compared to those collected after the first-day work shift
Summary
Healthcare-associated infections (HAIs) are the most frequent adverse events in healthcare delivery. Patients shed infectious microorganisms into the healthcare environment, and healthcare workers acquire these organisms, thereby transmitting the microorganisms further [4]. With the increasing prevalence of multidrug-resistant (MDR) bacteria in hospital settings, investigation of the role of environmental factors including medical professionals’ attire in the spread of infection is important [5]. Medical professionals’ white coat is associated with humanism and standard of professionalism [6]. At the Canadian Journal of Infectious Diseases and Medical Microbiology same time, the bitter irony is white coats are known to harbor pathogenic bacteria transiently, transmitting the microbes in the hospital environment and predispose to the patients-to-patients transmission of infections [7, 8]. It has been suggested that nurses’ uniform is the missing link in breaking the chain of HAIs [11]
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