# 5304
Admittedly, I can’t help but think about MRSA (and other pathogenic nasties) every time a nurse slips a well worn BP cuff around my arm, or a doctor places the bell of his trusty stethoscope against my bare chest.
How long, I wonder, has it been since they’ve been sanitized for my protection?
Just as quickly, I decide I don’t really want to know as I surreptitiously reach for my bottle of alcohol hand sanitizer.
But it does explain why my B/P is always 10 points higher at the doctor’s office.
While I’ve long been germ-averse, my visceral reaction has grown stronger ever since I read Maryn McKenna’s vivid account of growing antimicrobial resistance in her book Superbug: The Fatal Menace of MRSA, which I reviewed last year here.
Luckily, awareness of the dangers of MRSA and other pathogens has improved in the health care industry – and while serious infection control gaps remain – policies are being introduced to try to reduce the risks.
In recent years, physician’s ties, long coats, and long sleeves have all been pointed to as potential carriers of pathogens as doctors make their rounds from one patient to the next.
While the science behind these suspicions has been scant, some hospitals have invoked a `no-tie’ policy, while others have barred the wearing of long sleeved coats.
Today, in the Journal of Hospital Medicine, we get a study that looks at the level of bacterial contamination (including MRSA) on long sleeve coats compared with newly laundered short-sleeved uniforms worn by 100 physicians, and bacterial counts on their wrists wearing either garment.
The good news is, after 8 hours of wear, no difference was observed in the degree of bacterial contamination of freshly laundered short sleeve uniforms versus infrequently laundered white coats.
The slightly less reassuring flip side to this finding was that after 8 hours of wear, both groups were equally colonized with bacteria.
Exactly how contaminated both cohorts were, unfortunately, was not revealed in the study’s abstract.
Original Research
Marisha Burden MD,Lilia Cervantes MD, Diane Weed MA, MT, Angela Keniston, Connie S. Price MD, Richard K. Albert MD
As this study is in a pay-to-view journal, we are lucky to have more details available from the press release.
Contact: Jennifer Beal
healthnews@wiley.com
44-012-437-70633
Wiley-BlackwellLong- and short-sleeved physician workwear receive same amount of bacterial and MRSA contamination
Governmental agencies in the United Kingdom recently instituted guidelines banning physicians' white coats and the wearing of long-sleeved garments to decrease the transmission of bacteria within hospitals due to the belief that cuffs of long-sleeved shirts carry more bacteria. However, a new study published today in the Journal of Hospital Medicine shows that after an eight-hour day, there is no difference in contamination of long- and short-sleeved shirts, or on the skin at the wearers' wrists.
A group of researchers from the University of Colorado, USA, decided to assess the accuracy of the assumption that longer sleeves lead to more contamination by testing the uniforms of 100 physicians at Denver Health randomly assigned to wearing a freshly washed, short-sleeved uniform or their usual long-sleeved white coat. "We were surprised to find no statistical difference in contamination between the short- and long-sleeved workwear," said lead researcher Marisha Burden, MD. "We also found bacterial contamination of newly laundered uniforms occurs within hours of putting them on."
50 physicians were asked to start the day of the trial in a standard, freshly washed, short-sleeved uniform, and the 50 physicians wearing their usual long-sleeved white coats were not made aware of the trial date until shortly before the cultures were obtained, to ensure that they did not change or wash their coats. Cultures were taken from the physicians' wrists, cuffs and pockets. No significant differences were found in bacteria colony counts between each style.
The researchers also found that although the newly laundered uniforms were nearly sterile prior to putting them on, by three hours of wear nearly 50% of the bacteria counted at eight hours were already present.
"By the end of an eight-hour work day, we found no data supporting the contention that long-sleeved white coats were more heavily contaminated than short-sleeved uniforms. Our data do not support discarding white coats for uniforms that are changed on a daily basis, or for requiring health care workers to avoid long-sleeved garments," concluded Burden.
While I’m somewhat placated by these results, I doubt that I’ll be completely comfortable until I’m able to retrofit the shower at my place to dispense 62% alcohol gel.
Not that I’m germ phobic, or anything.
