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A Crossover Trial of Antimicrobial Scrubs to Reduce Methicillin-Resistant Staphylococcus aureus Burden on Healthcare Worker Apparel

Published online by Cambridge University Press:  02 January 2015

Gonzalo M. L. Bearman ,
Adriana Rosato ,
Kara Elam ,
Kakotan Sanogo ,
Michael P. Stevens ,
Curtis N. Sessler  and
Richard P. Wenzel
Gonzalo M. L. Bearman*
Affiliation:
Epidemiology and Infection Control, Virginia Commonwealth University, Richmond, Virginia
Adriana Rosato
Affiliation:
Epidemiology and Infection Control, Virginia Commonwealth University, Richmond, Virginia
Kara Elam
Affiliation:
Epidemiology and Infection Control, Virginia Commonwealth University, Richmond, Virginia
Kakotan Sanogo
Affiliation:
Epidemiology and Infection Control, Virginia Commonwealth University, Richmond, Virginia
Michael P. Stevens
Affiliation:
Epidemiology and Infection Control, Virginia Commonwealth University, Richmond, Virginia
Curtis N. Sessler
Affiliation:
Division of Pulmonary and Critical Care Medicine, Virginia Commonwealth University, Richmond, Virginia
Richard P. Wenzel
Affiliation:
Epidemiology and Infection Control, Virginia Commonwealth University, Richmond, Virginia
*
Epidemiology and Infection Control, Virginia Commonwealth University, Richmond, VA 23298 ([email protected])
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Abstract

Background.

The impact of antimicrobial scrubs on healthcare worker (HCW) bacterial burden is unknown.

Objective.

To determine die effectiveness of antimicrobial scrubs on hand and apparel bacterial burden.

Design.

Prospective, crossover trial.

Setting and Participants.

Thirty HCWs randomized to study versus control scrubs in an intensive care unit.

Methods.

Weekly microbiology samples were obtained from scrub abdominal area, cargo pocket, and hands. Mean log colony-forming unit (CFU) counts were calculated. Compliance with hand hygiene practices was measured. Apparel and hand mean log CFU counts were compared.

Results.

Adherence measures were 78% (910/1,173) for hand hygiene and 82% (223/273) for scrubs. Culture compliance was 67% (306/460). No differences were observed in bacterial hand burden or in HCWs with unique positive scrub cultures. No difference in vancomycin-resistant enterococci (VRE) and gram-negative rod (GNR) burden was observed. A difference in mean log mediicillin-resistant Staphylococcus aureus (MRSA) CFU count was found between study and control scrubs for leg cargo pocket (mean log CFUs, 11.84 control scrub vs 6.71 study scrub; P = .0002), abdominal area (mean log CFUs, 11.35 control scrub vs 7.54 study scrub; P = .0056), leg cargo pocket at die beginning of shift (mean log CFUs, 11.96 control scrub vs 4.87 study scrub; P = .0028), and abdominal area pocket at die end of shift (mean log CFUs, 12.14 control scrubs vs 8.22 study scrub; P = .0054).

Conclusions.

Study scrubs were associated witfi a 4–7 mean log reduction in MRSA burden but not VRE or GNRs. A prospective trial is needed to measure die impact of antimicrobial impregnated apparel on MRSA transmission rates.

Infect Control Hosp Epidemiol 2012;33(3):268-275

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 3 , March 2012 , pp. 268 - 275
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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