A crossover trial of antimicrobial scrubs to reduce methicillin-resistant Staphylococcus aureus burden on healthcare worker apparel.
BACKGROUND
The impact of antimicrobial scrubs on healthcare worker (HCW) bacterial burden is unknown. Objective. To determine the effectiveness of antimicrobial scrubs on hand and apparel bacterial burden.


METHODS
Prospective, crossover trial.


METHODS
Thirty HCWs randomized to study versus control scrubs in an intensive care unit.


METHODS
Weekly microbiology samples were obtained from scrub abdominal area, cargo pocket, and hands. Mean log colony-forming unit (CFU) counts were calculated. Compliance with hand hygiene practices was measured. Apparel and hand mean log CFU counts were compared.


RESULTS
Adherence measures were 78% (910/1,173) for hand hygiene and 82% (223/273) for scrubs. Culture compliance was 67% (306/460). No differences were observed in bacterial hand burden or in HCWs with unique positive scrub cultures. No difference in vancomycin-resistant enterococci (VRE) and gram-negative rod (GNR) burden was observed. A difference in mean log methicillin-resistant Staphylococcus aureus (MRSA) CFU count was found between study and control scrubs for leg cargo pocket (mean log CFUs, 11.84 control scrub vs 6.71 study scrub; [Formula: see text]), abdominal area (mean log CFUs, 11.35 control scrub vs 7.54 study scrub; [Formula: see text]), leg cargo pocket at the beginning of shift (mean log CFUs, 11.96 control scrub vs 4.87 study scrub; [Formula: see text]), and abdominal area pocket at the end of shift (mean log CFUs, 12.14 control scrubs vs 8.22 study scrub; [Formula: see text]).


CONCLUSIONS
Study scrubs were associated with a 4-7 mean log reduction in MRSA burden but not VRE or GNRs. A prospective trial is needed to measure the impact of antimicrobial impregnated apparel on MRSA transmission rates.
Epidemiology and Infection Control, Virginia Commonwealth University, Richmond, Virginia WI 53705, USA. gbearman@mcvh-vcu.edu
Gonzalo M L
GM
Bearman
Adriana
A
Rosato
Kara
K
Elam
Kakotan
K
Sanogo
Michael P
MP
Stevens
Curtis N
CN
Sessler
Richard P
RP
Wenzel
D000046:Academic Medical Centers; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission; D018592:Cross-Over Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006235:Hand Disinfection; D006801:Humans; D007362:Intensive Care Units; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D011481:Protective Clothing / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000517:prevention & control* / Q000635:transmission; D011795:Surveys and Questionnaires
D000890:Anti-Infective Agents