White coats: how much safe are they?

Abstract

Background: Various studies have suggested that health care workers'(HCW) clothing, including white coats, are potential reservoirs for microorganisms causing health care associated infections, reinfecting the hands of HCWs and may be a vector for transmission of nosocomial pathogens. Hence the present study was undertaken to detect the incidence of pathogenic microorganisms that contaminate nurses white coats. Methods: Total 324 swabs, collected by swabbing the three sites of the surface of the Nurses’ white coat (pockets, abdominal zone and the sleeve ends) were inoculated on blood agar, Mac-Conkey’s agar and incubated at 37°C overnight. Microbial growth was identified by standard methods. Antibiotic sensitivity test was carried out by Kirby-Baur disc diffusion method as per CLSI guidelines. Results: Non-pathogenic bacteria (skin flora) were isolated from all white coat culture and pathogenic bacteria from 76 (70.3%) white coats (45 from Surgery & allied departments, 31 from Medicine & allied departments). From total 324 samples, 85 (26.2%) samples were positive for pathogenic bacteria and total 94 pathogenic bacteria were isolated which includes 33 (35.1%) Staphylococcus aureus (6 MRSA, 27 MSSA), 56 gram negative bacilli (17 ESBL producers). The rate of contamination with pathogens, was higher on pockets (57.4%) compared with abdominal zone (27.6%) and sleeve ends (14.8%).   Conclusions: The study highlights the importance of white coats as potential source of cross infection. A strict protocol should be followed for preventing cross-contamination from the white coats.