Clothing as microbial fomites in an equine veterinary hospital—Could interventions reduce nosocomial infection risk?

Abstract

Background: Clothing in human medical environments has been shown to be contaminated with micro-organisms. There is little work in this area in the veterinary environment and none in equine veterinary environments. Objectives: To characterise microbial contamination of veterinary clothing throughout a work shift in an equine hospital. The pattern could help determine whether an intervention could reduce contamination. Study Design: Cross-sectional, observational pilot study of staff at B&W Equine Hospital in February 2023. The study used convenience sampling of staff clothing. Methods: Ninety-two swabs from the clothing of 46 staff were taken at three time points (start of the day [AM], lunch and end of the day [PM]). Samples were cultured with colony-forming units (CFUs) per swab, and the genus of the microbe present was identified. Statistical analysis was performed. Results: Five genera of microbes were identified on clothing. Veterinarians became significantly more contaminated from AM to PM (p = 0.034). All groups of staff arrived at work already contaminated. All AM samples from staff had Streptococcus spp. present. Rhodococcus spp. were not present on nonclinical staff. Main Limitations: Small sample size not representative of all equine hospitals. Hospital-based not representative of ambulatory practices. Volunteer bias and the use of a nonprobability sampling method. Genetic sequencing not performed to determine the species of the microbe present. Conclusion: This study found that veterinarians became significantly more contaminated throughout the day. This suggests that a simple intervention such as changing outer layers of clothing at lunchtime could reduce contamination levels. All groups were contaminated on arrival to work, suggesting that in-house laundering to regulate the cleanliness of uniforms could reduce microbial contamination. To reach a full conclusion on the diversity of contamination, further research, including full identification of microbes, is required.