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Abstract
Background
Doctors' white coats and neckties can become contaminated with potentially pathogenic bacteria and have a possibility of causing cross infections. Our objective was to determine the level of bacterial contamination and detect methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and Clostridium difficile present on the white coats and neckties of residents.
Methods
We sampled 28 long-sleeved white coats and 14 neckties worn by residents. The tested sites for white coats were the cuffs and lower front surfaces, and for neckties, the lower surfaces. Impressions of these sites were taken with the plates containing blood agar (BAP), mannitol salt agar supplemented with oxacillin (6μg/mL), enterococcus screening agar supplemented with vancomycin (6μg/mL) and phenyl ethanol agar. The colonies grown on each plate were Gram stained and identified by standard microbiological methods.
Results
Of the 28 white coats, 7 (25.0%) carried MRSA, and of the 14 neckties, 1 (7.1%) carried MRSA. The majority of white coats (96.4%) and all neckties (100.0%) carried methicillin-resistant coagulase negative staphylococci (MRCNS). None of the white coats and neckties carried VRE or C. difficile.
REFERENCES
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Table 1.
Total and MRSA colony counts on white coats and neckties worn by 28 residents
| No. case | Specialty | Sex | Time in use (days) | Location on white coat | Necktie∗ | ||||
|---|---|---|---|---|---|---|---|---|---|
| Cuff | Front surface | ||||||||
| Total colony counts on BAP | MRSA colony counts on MSO | Total colony counts on BAP | MRSA colony counts on MSO | Total colony counts on BAP | MRSA colony counts on MSO | ||||
| 1 | Medical | M | 2 | 23 | - | 44 | - | 18 | - |
| 2 | Medical | F | 2 | 23 | - | 19 | - | NA | NA |
| 3 | Medical | F | 2 | 38 | 6 | 60 | 6 | NA | NA |
| 4 | Medical | F | 3 | 24 | - | 25 | - | NA | NA |
| 5 | Medical | F | 3 | 16 | - | 49 | - | NA | NA |
| 6 | Medical | M | 5 | 15 | - | 63 | - | 57 | - |
| 7 | Medical | M | 7 | 21 | - | 9 | - | 10 | - |
| 8 | Medical | M | 7 | 22 | - | 37 | - | 14 | - |
| 9 | Medical | M | 7 | 21 | - | 9 | - | 32 | - |
| 10 | Medical | M | 7 | 19 | 10 | 5 | 1 | NA | NA |
| 11 | Medical | F | 7 | 40 | - | 35 | - | NA | NA |
| 12 | Medical | F | 7 | 55 | - | 43 | - | NA | NA |
| 13 | Medical | M | 10 | 24 | - | 32 | - | 11 | - |
| 14 | Medical | F | 10 | 62 | - | 94 | - | NA | NA |
| 15 | Medical | F | 14 | 70 | - | 22 | - | NA | NA |
| 16 | Medical | F | 14 | 40 | - | 24 | - | NA | NA |
| 17 | Medical | F | 15 | 35 | 35 | 23 | 20 | NA | NA |
| 18 | Medical | M | 30 | 45 | - | 64 | - | 72 | - |
| 19 | Sugical | M | 1 | 8 | - | 6 | - | 4 | - |
| 20 | Sugical | M | 4 | 61 | - | 36 | 3 | 15 | 1 |
| 21 | Sugical | M | 5 | 53 | 1 | 15 | - | NA | NA |
| 22 | Sugical | F | 6 | 5 | - | 21 | 10 | NA | NA |
| 23 | Sugical | M | 7 | 76 | - | 18 | - | 15 | - |
| 24 | Sugical | M | 7 | 130 | 16 | 41 | 20 | 220 | - |
| 25 | Sugical | M | 10 | 48 | - | 20 | - | 56 | - |
| 26 | Sugical | M | 28 | 37 | - | 62 | - | NA | NA |
| 27 | Sugical | M | 30 | 21 | - | 43 | - | 12 | - |
| 28 | Sugical | M | 30 | 4 | - | 26 | - | 13 | - |
∗ A total of 14 neckties was tested, each 7 neckties were collected from residents in medical and surgical specialty, respectively.
Abbreviations: MRSA, methicillin-resistant Staphylococcus aureus; BAP, blood agar plate; MSO, mannitol salt agar supplemented with 6μg/mL oxacillin; NA, not applicable.
Table 2.
Numbers of contaminated white coats and neckties with colony counts
| Total colony counts on BAP | Location on white coat | Necktie (n=14) | Total (n=70) | |
|---|---|---|---|---|
| Cuff (n=28) | Front surface (n=28) | |||
| 0∼19 | 6 | 7 | 9 | 22 |
| 20∼39 | 11 | 11 | 1 | 23 |
| 40∼59 | 6 | 5 | 2 | 13 |
| 60∼79 | 4 | 4 | 1 | 9 |
| 80∼99 | 0 | 1 | 0 | 1 |
| ＞100 | 1 | 0 | 1 | 2 |
| Mean∗ | 34.7 | 32.5 | 27.1 | 32.4 |
Table 3.
Numbers of white coats and neckties contaminated with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE) and Clostridium difficile by specialty
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