A crossover trial of antimicrobial scrubs to reduce methicillin-resistant Staphylococcus aureus burden on healthcare worker apparel

Infect Control Hosp Epidemiol. 2012 Mar;33(3):268-75. doi: 10.1086/664045. Epub 2012 Jan 6.

Abstract

Background: The impact of antimicrobial scrubs on healthcare worker (HCW) bacterial burden is unknown. Objective. To determine the 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 methicillin-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; [Formula: see text]), abdominal area (mean log CFUs, 11.35 control scrub vs 7.54 study scrub; [Formula: see text]), leg cargo pocket at the beginning of shift (mean log CFUs, 11.96 control scrub vs 4.87 study scrub; [Formula: see text]), and abdominal area pocket at the end of shift (mean log CFUs, 12.14 control scrubs vs 8.22 study scrub; [Formula: see text]).

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

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Academic Medical Centers
  • Anti-Infective Agents / therapeutic use*
  • Colony Count, Microbial
  • Cross Infection / prevention & control*
  • Cross Infection / transmission
  • Cross-Over Studies
  • Guideline Adherence / statistics & numerical data
  • Hand Disinfection
  • Humans
  • Intensive Care Units
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Protective Clothing / microbiology*
  • Staphylococcal Infections / prevention & control*
  • Staphylococcal Infections / transmission
  • Surveys and Questionnaires

Substances

  • Anti-Infective Agents