Microbiology: A Systems Approach 4th Edition by Marjorie Kelly Cowan

Exercise 26

Hospital Workers: What's Coming Home on Your Clothing
It's not an uncommon sight in the health care field: tired doctors, nurses, and technicians leaving the hospital at the end of their shift, heading to their cars and home to their loved ones. What do they all have in common, in addition to being exhausted after a long shift They are all wearing hospital scrubs. To a member of the general public, this may seem innocuous and does nothing more than identify someone as a health care worker by his or her attire. As a microbiology student, this should raise some red flags: These workers, whether they are doctors, nurses, respiratory technicians, X-ray technicians, phlebotomists, or even custodial staff, have been exposed to microbes in the hospital and may be carrying them on their clothing.
Why is the clothing of health care workers any different than clothing that you're wearing Everyone carries resident biota , or bacteria on the skin that is rubbed off into clothing, and everyone comes into contact with environmental surfaces, other people, and animals harboring microbes that may be transferred onto their clothing or skin. The difference is the hospital setting. Healthcare-associated or nosocomial infections are not uncommon, and many of these infections are passed from patient to patient via hospital staff. Health care workers are exposed to potential pathogens through aerosolized body fluids or through direct contact with patients and their body fluids. Even without visible stains from blood, feces, urine, mucus, or other emissions, microscopic particles can become embedded in the clothing. Because the hospital can be the source of multidrug-resistant bacteria and other potential pathogens, the contamination of hospital clothing can increase the risk for transmission of these microbes to the cars, homes, and loved ones of health care workers.
How common is contamination of hospital scrubs among health care workers
What microbes most commonly are found on the clothing of health care workers
Is laundering at home sufficient to remove microbial contamination
Researchers in Israel collected swab samples from the uniforms of registered nurses (RNs) and medical doctors (MDs), testing the ends of sleeves, the abdominal region, and pockets. The samples were pressed onto blood agar plates to detect microbial growth. Microbial pathogens were isolated from 63% of those sampled; multidrug- resistant Staphylococcus aureus (MRSA) was isolated from 21 cultures of RN uniforms and 6 cultures of MD uniforms.
In another study researchers sampled hospital surfaces and clothing that were routinely touched by health care workers. The results showed that 75% of white lab coats were contaminated with Pseudomonas oryzihabitans , MRSA, and Moraxella , among other pathogens. Doctors' ties were also sampled, and 66% were contaminated with MRSA and other pathogens.
Many hospitals allow hospital workers to launder their own uniforms as a cost-saving measure; often, scrubs and white lab coats are taken home and washed together with personal clothing items at varying temperatures and with different detergents. The main difference between a hospital laundry and a home laundry is the water temperature-hospital laundry water can reach 160°F and home laundry can reach only 130°F on the hottest setting, which may not destroy all pathogens. A recent study in the journal Infection Control and Hospital Epidemiology showed that hot water with detergent killed MRSA but was only moderately successful against Acinetobacter , an organism known to have resistance to multiple antibiotics. If clothes are washed with warm water but not detergent, MRSA is removed, but the clothing becomes contaminated by Enterobacter , Serratia , and Klebsiella , all gram-negative organisms found in fecal material. Another study showed that homelaundered scrubs showed significantly higher levels of coliform bacteria than hospital-laundered scrubs.
What are the guidelines for the laundering of potentially contaminated hospital clothing
What measures are being taken to reduce the levels of bacteria on hospital clothing
Sources : 2011. Infect. Contr. Hosp. Epidem. vol. 32, no. 11, p. 1103. 2011. Am. J. Infect. Contr. vol. 39, no. 7, p. 555.