MICROBIAL CARRIAGE OF HOSPITAL UNIFORMS AMONG EMERGENCY MEDICINE RESIDENTS AT THE UNIVERSITY OF THE PHILIPPINES – PHILIPPINE GENERAL HOSPITAL (UP-PGH)
Keywords:
Microbial carriage, hospital uniforms, emergency medicine residents, UP-PGH
Abstract
The aim of this research is to identify the microbial flora and pathogen of hospital uniforms (HUs) among emergency medicine (EM) residents at the University of the Philippines – Philippine General Hospital (UP-PGH) and to determine factors affecting their presence. A prospective, cross-sectional design that sampled and cultured bacterial contaminants on hospital uniforms of EM residents at UP-PGH over a 10-day period from 13-23 April 2021 was utilized. Frequency distribution, z-test and chi-square test at p <0.05 statistical significance were used for the data analysis. A total of 22 EM residents, with a mean age of 30 (± 2.77) years participated in the study; more than half were females (54.5%) and went on evening (1900-0700hrs) duty shift (63.6%). Handwashing was done by 45.5% and 77.3% prior to and after seeing a patient respectively. Increases in the proportion of bacterial isolation in the after-duty samples were significantly noted for S. epidermidis at the right pocket (p<0.01), torso (p<0.01), and sleeve (p<0.01). Moderate growth of the bacteria was significantly associated with the morning shift (0700-1900 hours). Hospital uniforms can harbor pathogens and other harmful microorganisms as it is regularly exposed to the hospital environment. Given the growing number of nosocomial infections and increasing bacterial resistance to antibiotics, it is recommended to enforce infection control hospital policies that emphasize the importance of wearing HUs only at the workplace and prohibit its usage in public places. This should include regularly providing freshly laundered HUs, related sterilization services and proper storage.
References
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[2] J. Wilson, H. Loveday, P. Hoffman and R. Pratt, "Uniform: an evidence review of the microbiological significance of uniforms and uniform policy in the prevention and control of healthcare-associated infections. Report to the Department of Health (England)," Journal of Hospital Infection, vol. 66, no. 4, pp. 301-307, Aug 2007.
[3] G. Demmler-Harrison, "Healthcare-associated viral infections: considerations for nosocomial transmission and infection control," Healthcare-associated Infections in Children, pp. 229-257, January 2019.
[4] Y. Wiener-Well, M. Galuty, B. Rudensky, Y. Schlesinger, D. Attias and A. M. Yinnon, "Nursing and physician attire as possible source of nosocomial infections," American Journal of Infection Control, vol. 39, no. 7, pp. 555-559, 2011.
[5] H. S. Vikke and M. Giebner, "UniStatus - a cross-sectional study on the contamination of uniforms in the Danish ambulance service," BMC Research Notes, vol. 8, no. 95, March 2015.
[6] M. G. Lankford, S. Collins, L. Youngberg, D. M. Rooney, J. R. Warren and G. A. Noskin, "Assessment of materials commonly utilized in health care: Implications for bacterial survival and transmission," American Journal of Infection Control, vol. 34, no. 5, pp. 258-263, June 2006.
[7] A. M. Treakle, K. A. Thom, J. P. Furuno, S. M. Strauss, A. D. Harris and E. N. Perencevich, "Bacterial contamination of health care workers’white coats," American Journal of Infection Control, vol. 37, no. 2, pp. 101-105, Oct 2008.
[8] H. Loveday, J. Wilson, R. Pratt, M. Golsorkhi, A. Tingle, A. Bak, J. Browne, J. Prieto and M. Wilcox, "epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England," Ournal of Hospital Infection, vol. 86, no. Supplement 1, pp. S1-S70, January 2014.
[9] M. Burden, L. Cervantes, D. Weed, A. Keniston, C. S. Price and R. K. Albert, "Bacterial Contamination of Workwear," Journal of Hospital Medicine, vol. 6, no. 4, pp. 177-182, 2011.
[10] C. Perry, R. Marshall and E. Jones, "Bacterial contamination of uniforms," Journal of Hospital Infection, vol. 48, no. 3, pp. 238-241, 2001.
[11] Y. Bouwman, V. Fenton-May and P. Le Brun, Practical Pharmaceutics.An International Guideline for the Preparation, Care and Use of Medicinal Products, KNMP and Springer International Publishing Switzerland, 2015.
[12] M. Cockcroft, D. Hepworth, J. Rhodes and P. Addison, "Validation of liquid disinfection techniques fo transfer of components into hospital pharmacy clean room," Hospital Pharmacist, vol. 8, no. 8, pp. 226-232, 2001.
[13] CLSI, Performance Standards For Antimicrobial Susceptibility Testing, 27th ed., vol. CLSI supplement M100, Wayne, Pennsylvania: Clinical and Laboratory Standards Institute, 2017.
[14] K. Zachary, P. Bayne, V. Morrison, D. Ford, L. Silver and D. Hooper, "Contamination of gowns, gloves, and stethoscopes with vancomycin-resistant enterococci," Infectin Control & Hospital Epidemiology, vol. 22, no. 9, pp. 560-4, Sept 2001.
[15] G. M. Snyder, K. A. Thom, J. P. Furruno, E. N. Perencevich, M.-C. Roghmann, S. M. Strauss, G. Netzer and A. Harris, "Detection of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on the gowns and gloves of healthcare workers," Infection Control & Hospital Epidemiology, vol. 29, no. 7, pp. 583-9, 2008.
[16] J. Otter and G. French, "Bacterial contamination on touch surfaces in the public transport system and in public areas of a hospital in London," Letters in Applied Microbiology, vol. 49, no. 6, pp. 803-5, Aug 2009.
[17] M. Ohl, M. Schweizer, M. Graham, K. Heilmann, L. Boyken and D. Diekema, "Hospital privacy curtains are frequently and rapidly contaminated with potentially pathogenic bacteria," American Journal of Infection Control, vol. 40, no. 10, pp. 904-906, December 2012.
[18] S. Butterfield, "The white coat of the future," Infection Control_ACP Hospitalist, 2011.
[19] L. Sehulster, "Healthcare Laundry and Textiles in the United States: Review and Commentary on Contemporary Infection Prevention Issues," Infect Control Hosp Epidemiol, vol. 36, no. 9, pp. 1073-88, Sept 2015.
[20] D. Bockmühl, J. Schages and L. Rehberg, "Laundry and textile hygiene in healthcare and beyond," Microbial cell , vol. 6, no. 7, p. 299–306, 2019.
[21] C. A. Krueger, C. K. Murray, K. Mende, C. Guymon and T. L. Gerlinger, "The bacterial contamination of surgical scrubs," American Journal of Orthopedics, vol. 41, no. 5, pp. E69-73, May 2012.
[22] G. West, M. Resendiz, M. Lustik and M. Nahid, "Bacterial Contamination of Military and Civilian Uniforms in an Emergency Department,," Journal of Emergency Nursing, vol. 45, no. 2, pp. 169-177.e1, 2019.
[23] E. Tajeddin, M. Rashidan, M. Razaghi, S. Javadi, S. Sherafat, M. Alebouyeh, M. Sarbazi, N. Mansouri and M. Zali, "The role of the intensive care unit environment and health-care workers in the transmission of bacteria associated with hospital acquired infections," Journal of Infection and Public Health, vol. 9, no. 1, pp. 13-23, 2016.
[24] J. Siegel, E. Rhinehart, M. Jackson and L. Chiarello, "2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings," American Journal of Infection Control, vol. 35, no. Suppl 2, pp. S65-164, December 2007.
[25] S. Bloomfield, M. Exner, C. Signorelli, K. J. Nath and E. Scott, "The infection risks associated with clothing and household linens in home and everyday life settings, and the role of laundry," International Scientific Forum on Home Hygiene, 2011.
[26] D. J. Morgan, E. Rogawski, K. A. Thom, J. K. Johnson, E. N. Perencevich, M. Shardell, S. Leekha and A. Harris, "Transfer of multidrug-resistant bacteria to healthcare workers’ gloves and gowns after patient contact increases with environmental contamination," Critical Care Medicine, vol. 40, no. 4, pp. 1045-1051, 2012.
[27] M. Brown and A. Horswill, "Staphylococcus epidermidis—Skin friend or foe?," PLoS Pathog, no. https://doi.org/10.1371/journal.ppat.1009026, p. 16(11): e1009026., 2020.
[28] M.-A. Sanon and S. Watkins, "Nurses' uniforms: How many bacteria do they carry after one shift?," Journal of public health and epidemiology, Vols. vol. 4,10, no. doi:10.5897/JPHE12.074, pp. 311-315, 2012.
[29] M. A. Radwan and M. Ahmad, "The Microorganisms on Nurses and Health-Workers’ Uniforms in the Intensive Care Units," Clinical Nursing Research, no. 28. 10.1177/1054773817708934., 2017.
[30] Y. Wiener-Well, M. Galuty, B. Rudensky, Y. Schlesinger, D. Attias and A. Yinnon, "Nursing and physician attire as possible source of nosocomial infections," American Journal of Infection Control, vol. 39, no. 7, pp. 555-9, September 2011.
[31] J. Bayuo, E. Obour, F. Bonsu, F. Agyei, A. Asante, D. Abeasi, S. Akyem and S. Nabaale, "Bacterial Profile of Nurses’ Uniforms: A Descriptive Cross-sectional Study," Research Square, no. https://doi.org/10.21203/rs.3.rs-127402/v1, 17 December 2020.
Published
2022-04-30
How to Cite
Dominado, T. M., & Tabunar, S. M. S. (2022). MICROBIAL CARRIAGE OF HOSPITAL UNIFORMS AMONG EMERGENCY MEDICINE RESIDENTS AT THE UNIVERSITY OF THE PHILIPPINES – PHILIPPINE GENERAL HOSPITAL (UP-PGH). Malaysian Journal of Public Health Medicine, 22(1), 284-294. https://doi.org/10.37268/mjphm/vol.22/no.1/art.1575
Section
Articles
