title: Evaluation of the protective value of hospital gowns against blood strike-through and methicillin-resistant Staphylococcus aureus penetration.
abstract: BACKGROUND
  Hospital gowns protect patients and health care workers from exposure to blood and other infectious materials. Previous studies have shown that certain gowns do allow blood strike-through. Because of worldwide increases in the incidence of Staphylococcus aureus infections, especially with methicillin-resistant strains, there is now increased concern regarding bacterial transmission through gowns.
  
  
  METHODS
  This study evaluated six gown types used in hospitals (one disposable cover or isolation gown, three disposable operating room gowns, and new and washed reusable operating room gowns). Gowns were evaluated for dry spore and S. aureus filtration efficiencies and were subjected to 20 time-pressure combinations with methicillin-resistant S. aureus-spiked blood (10(4)/ml) to evaluate blood strike-through and passage of methicillin-resistant S. aureus.
  
  
  RESULTS
  Blood strike-through was lowest with disposable operating room gowns 1 and 2 (polypropylene). Disposable operating room gown 3 (polyester-wood pulp) showed the greatest strike-through and overall passage of methicillin-resistant S. aureus. Operating room gowns 1 and 2 showed minimal bacterial passage, whereas the disposable cover (polypropylene) only allowed passage at pressures greater than 1 psi. Bacterial filtration efficiency testing showed operating room gowns 1 and 2 to be the most protective; operating room gown 3 and both reusable (cotton) gowns were the least protective. Dry spore passage was greatest for reusable gowns.
  
  
  CONCLUSIONS
  Different hospital gowns offer varying degrees of protection against fluid strike-through or bacterial passage. Gowns therefore should be chosen according to the task performed and conditions encountered.
authors.affiliation: Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112-2699, USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Granzow
authors.forename: J W
authors.initials: JW
authors.lastname: Smith
authors.forename: R L
authors.initials: RL
authors.lastname: Nichols
authors.forename: R S
authors.initials: RS
authors.lastname: Waterman
authors.forename: A C
authors.initials: AC
authors.lastname: Muzik
mesh_terms: D000704:Analysis of Variance; D001412:Bacillus subtilis / Q000302:isolation & purification; D017848:Blood-Borne Pathogens; D003257:Consumer Product Safety; D004209:Disposable Equipment; D017743:Equipment Reuse; D005069:Evaluation Studies as Topic; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008145:Louisiana; D016106:Methicillin Resistance; D016273:Occupational Exposure / Q000517:prevention & control*; D009873:Operating Rooms; D010564:Personnel, Hospital; D011481:Protective Clothing / Q000382:microbiology*; D012869:Skin Absorption; D013170:Spores; D013203:Staphylococcal Infections / Q000517:prevention & control / Q000635:transmission*; D013211:Staphylococcus aureus / Q000302:isolation & purification