Surgical scrubs embedded with antimicrobials do not reduce contamination in ICUs

Surgical scrubs impregnated with an antimicrobial compound did not reduce contamination of health care providers’ clothing in an ICU, according to findings published in Infection Control and Hospital Epidemiology.

“Health care textiles, including curtains, sheets and clothing, are frequently contaminated with epidemiologically important pathogens such as MRSA, vancomycin-resistant enterococci and Clostridium difficile,” Deverick J. Anderson, MD, MPH, associate professor of medicine at Duke University, and colleagues wrote. “Clothing of [health care providers] routinely becomes contaminated during clinical duties, and it may serve as a source for transmission to patients or recontamination of the [health care provider] or the environment. Antimicrobial-impregnated textiles may decrease the acquisition and transmission of pathogens by [health care provider] clothing.”

The researchers performed a blinded, randomized controlled trial of 40 nurses. All nurses received three sets of scrubs: one set of standard cotton-polyester scrubs (control), a second with a compound that included a silver alloy embedded in the fibers (Scrub 1) and a third containing an organosilane-based quaternary ammonium and a hydrophobic fluoroacrylate copolymer emulsion (Scrub 2). All nurses worked in medical and surgical ICUs in a tertiary care hospital, and were spread across three consecutive 12-hour shifts. Anderson and colleagues collected cultures from the nurses, high-touch surfaces in the unit, and patients.

The researchers analyzed 2,919 cultures from the environment and 2,185 from the nurses’ clothes. There was no association between the type of scrubs worn by personnel and a change in clothing contamination, Anderson and colleagues wrote.

Compared with the control group, the estimated mean difference for the Scrub 1 arm was 0.118 (95% CI, –0.206 to 0.441; P = .48), and .009 for Scrub 2 (95% CI, –0.323 to 0.342; P = .96).

“Contamination of [health care providers] is an important component of pathogen transmission in health care settings,” the researchers wrote. “Results from our randomized controlled trial demonstrated that antimicrobial-impregnated scrubs were not efficacious at reducing nurse contamination and, thus, are not a useful strategy for stopping the movement of pathogens in the transmission triangle. We conclude that until additional data are available, the best strategies to reduce the risk of [health care provider] clothing contamination remain diligent hand hygiene following all patient room entries and exits and, when appropriate, use of gowns and gloves, even if no direct patient care is performed.” – by Andy Polhamus

Disclosure: Anderson reports no relevant financial disclosures. Please see the fully study for a complete list of all other authors’ relevant financial disclosures.