Wong D, Nye K, Hollis P
Public Health Laboratory, East Birmingham Hospital.
BMJ. 1991;303(6817):1602-4. doi: 10.1136/bmj.303.6817.1602.
To determine the level and type of microbial contamination present on the white coats of doctors in order to assess the risk of transmission of pathogenic micro-organisms by this route in a hospital setting.
Cross sectional survey of the bacterial contamination of white coats in a general hospital.
East Birmingham Hospital, an urban general hospital with 800 beds.
100 doctors of different grades and specialties.
The cuffs and pockets of the coats were the most highly contaminated areas. The level of bacterial contamination did not vary with the length of time a coat had been in use, but it increased with the degree of usage by the individual doctor. Staphylococcus aureus was isolated from a quarter of the coats examined, more commonly from those belonging to doctors in surgical specialties than medical specialties. Pathogenic Gram negative bacilli and other pathogenic bacteria were not isolated.
White coats are a potential source of cross infection, especially in surgical areas. Scrupulous hand washing should be observed before and after attending patients and it may be advisable to remove the white coat and put on a plastic apron before examining wounds. There is little microbiological reason for recommending a more frequent change of white coat than once a week, nor for excluding the wearing of white coats in non-clinical areas.
确定医生白大褂上存在的微生物污染水平和类型，以评估在医院环境中通过这种途径传播致病微生物的风险。
对一家综合医院白大褂的细菌污染情况进行横断面调查。
东伯明翰医院，一家拥有800张床位的城市综合医院。
100名不同级别和专业的医生。
白大褂的袖口和口袋是污染最严重的部位。细菌污染水平并不随白大褂的使用时间长短而变化，但随医生个人的使用程度增加而升高。在四分之一的被检查白大褂上分离出了金黄色葡萄球菌，在外科专业医生的白大褂上比在内科专业医生的白大褂上更常见。未分离出致病性革兰氏阴性杆菌和其他病原菌。
白大褂是交叉感染的潜在来源，尤其是在外科区域。接触患者前后应严格洗手，检查伤口前脱掉白大褂并穿上塑料围裙可能是明智的。从微生物学角度来看，几乎没有理由建议比每周更换一次白大褂更频繁地更换，也没有理由禁止在非临床区域穿着白大褂。
