Student Nurse Scrubs May Carry S. Aureus
NEW
YORK (Reuters Health) - Scrub tops worn by student nurses may harbor
methicillin-sensitive Staphylococcus aureus (MSSA) even after
laundering, researchers say.
Dr. Elizabeth Scott, from Simmons College in Boston, and colleagues say contaminated student scrubs may carry the pathogen out of the hospital and into the community.
The researchers used two electronic surveys to gather information on 89 students' clinical work settings and laundry habits. Study participants also swabbed their scrub tops after shifts and again after laundering.
The researchers found no evidence of methicillin-resistant S. aureus (MRSA) on any pre- or post-laundry swabs, according to an article online July 2 in the American Journal of Infection Control.
However, 17% of pre-laundry swabs tested positive for MSSA after clinical shifts. Of these, 64.3% were clear of it after laundering and the rest remained positive.
Four scrubs that were negative for MSSA before laundering tested positive afterward. Use of hot water, bleach, ironing, or dryer time did not make a statistically significant difference in the clearance of MSSA. Neither did laundering.
Of the students surveyed, 31.5% lived on campus. Roughly half (51.7%) worked at academic medical centers, with 34.8% on medical surgical units.
Close to 60% of the student nurses spent two days per week on clinical duty. Approximately one-third of the patients they cared for were on contact precautions.
More than 90% of the students wore their scrubs to and from the hospital, and 37% wore them on campus after their shifts.
Close to 70% lived off campus and did not use dormitory laundry facilities.
The nursing students rarely followed safe laundering guidelines that include daily hot water washing with bleach, hot air drying, and ironing.
Nearly half left their scrubs in a hamper for at least two days before cleaning them. Just over 90% washed them with other items, and 46.1% used warm water.
Only 5.6% of the students used bleach. Over 85% tumble-dried their scrubs, but just 3.4% ironed them.
Dr. Scott said it's likely that nursing students around the country have similar laundry habits to the ones observed in the study.
"To help reduce the risk of infection transmission in the hospital setting, it's important to establish good habits during nursing training, including best practices regarding clinical scrubs," she told Reuters Health by email.
All the same, laundry routines may be of little consequence.
"S. aureus is common," said Dr. David Hooper, chief of infection control at Massachusetts General Hospital in Boston, who was not involved in the study. "One-quarter to one-third of the population normally carry it, usually in their noses," he explained.
According to Dr. Hooper, it's impossible to tell where the bacteria in the study came from. "We don't even know if the scrubs were contaminated in the hospital," he said, adding that the report can't be interpreted in any useful way due to problems with its design.
Dr. Pritish Tosh, an infectious disease physician and member of the Mayo Clinic Vaccine Research Group at Mayo Clinic in Rochester, Minnesota, told Reuters Health by phone that the small sample and lack of statistical significance made the findings questionable.
"Hand hygiene is the most important mode of transmission, not scrubs," he said.
Dr. Tosh, who wasn't involved in the study, still thinks it has some value. "It can open the door to further research on ideal laundering techniques as well as actual transmission of bacteria," he said.
SOURCE: http://bit.ly/1OhFoex
Am J Infect Control 2015.
Dr. Elizabeth Scott, from Simmons College in Boston, and colleagues say contaminated student scrubs may carry the pathogen out of the hospital and into the community.
The researchers used two electronic surveys to gather information on 89 students' clinical work settings and laundry habits. Study participants also swabbed their scrub tops after shifts and again after laundering.
The researchers found no evidence of methicillin-resistant S. aureus (MRSA) on any pre- or post-laundry swabs, according to an article online July 2 in the American Journal of Infection Control.
However, 17% of pre-laundry swabs tested positive for MSSA after clinical shifts. Of these, 64.3% were clear of it after laundering and the rest remained positive.
Four scrubs that were negative for MSSA before laundering tested positive afterward. Use of hot water, bleach, ironing, or dryer time did not make a statistically significant difference in the clearance of MSSA. Neither did laundering.
Of the students surveyed, 31.5% lived on campus. Roughly half (51.7%) worked at academic medical centers, with 34.8% on medical surgical units.
Close to 60% of the student nurses spent two days per week on clinical duty. Approximately one-third of the patients they cared for were on contact precautions.
More than 90% of the students wore their scrubs to and from the hospital, and 37% wore them on campus after their shifts.
Close to 70% lived off campus and did not use dormitory laundry facilities.
The nursing students rarely followed safe laundering guidelines that include daily hot water washing with bleach, hot air drying, and ironing.
Nearly half left their scrubs in a hamper for at least two days before cleaning them. Just over 90% washed them with other items, and 46.1% used warm water.
Only 5.6% of the students used bleach. Over 85% tumble-dried their scrubs, but just 3.4% ironed them.
Dr. Scott said it's likely that nursing students around the country have similar laundry habits to the ones observed in the study.
"To help reduce the risk of infection transmission in the hospital setting, it's important to establish good habits during nursing training, including best practices regarding clinical scrubs," she told Reuters Health by email.
All the same, laundry routines may be of little consequence.
"S. aureus is common," said Dr. David Hooper, chief of infection control at Massachusetts General Hospital in Boston, who was not involved in the study. "One-quarter to one-third of the population normally carry it, usually in their noses," he explained.
According to Dr. Hooper, it's impossible to tell where the bacteria in the study came from. "We don't even know if the scrubs were contaminated in the hospital," he said, adding that the report can't be interpreted in any useful way due to problems with its design.
Dr. Pritish Tosh, an infectious disease physician and member of the Mayo Clinic Vaccine Research Group at Mayo Clinic in Rochester, Minnesota, told Reuters Health by phone that the small sample and lack of statistical significance made the findings questionable.
"Hand hygiene is the most important mode of transmission, not scrubs," he said.
Dr. Tosh, who wasn't involved in the study, still thinks it has some value. "It can open the door to further research on ideal laundering techniques as well as actual transmission of bacteria," he said.
SOURCE: http://bit.ly/1OhFoex
Am J Infect Control 2015.
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