Effect of Antimicrobial Finish in Reducing Bacterial Load on White Coats

Abstract

Garments of health care workers are important aspects of the environment of a healthcare facility and are known to get contaminated with microbes during use. They can act as carriers as well as transmitters of infections. As the nurses work in the hospital the newly laundered uniforms may also get contaminated within hours of donning. Hence, there is a need of an effective strategy to prevent cross contamination by reducing the bio-burden on the surface of the uniforms/white coats. One of the strategies that can be used for microbial control is the use of antimicrobial finishes. Silver based antimicrobial finishes have been tested extensively in laboratories, but there are few studies which have been carried out in vivo, that are on fabrics and garments being used in a hospital under real life conditions. This paper investigates the efficacy of commercial silver based antimicrobial finish in reducing bacterial load on nurses’ white coats in a hospital. The study was conducted in 100 bedded tertiary care government hospital in Delhi. Polyester and polyester cotton blend fabric was treated with Antimicrobial (AM) finish. Swatches of 20cm x 10cm each were cut from both fabrics and stitched to make a composite patch of 20cm x 20cm. At the beginning of shift a composite patch of untreated and treated fabric respectively was stitched on the left and right side of the washed white coat of participating nurse. The patched coat was worn by the nurse during her shift after which the patches were removed and plated. Microbial contamination on polyester and blend fabrics after 6 hours shift was compared in Brain Heart Infusion broth (BHI). Isolates of Staphylococci, Salmonella, Streptococci, Pseudomonas Aeruginosa, Klebsiella, Escherichia coli (E. coli) and Vancomycin Resistant Enterococci (VRE) were studied in selective media. Untreated polyester and blend fabric showed a total bacterial count of 886 and 1525 CFUs respectively after the 6 hours shift. After treatment with antimicrobial finish, bacterial count on both fabrics reduced by 81%. Isolates of all seven bacteria were detected on all untreated swatches, ranging from 18 CFUs (VRE) to 440 CFUs (E. coli) on polyester and 46 CFUs (VRE) to 627 CFUs (E coli) on blend. Nearly 100% reduction in the number of colonies was observed for Salmonella, Streptococci, Pseudomonas Aeruginosa, Klebsiella and E. coli while 73.7% reduction in Staphylococci genus and 94.4% in VRE was observed. Use of a silver based antimicrobial finish can bring down bacterial contamination in nurses’ white coats by nearly 81% irrespective of the type of fabric used to make the coat. Antimicrobial finish can be an effective strategy in reducing the bacterial burden in hospital uniforms.