Impact of home versus hospital dressing on bacterial contamination of surgical scrubs in the obstetric setting: A randomized controlled trial.

BACKGROUND

The impact of the site where an obstetrician dresses in their surgical scrubs, home versus hospital, on total bacterial burden remains unknown. Therefore, our objective was to quantify the effect of dressing in surgical scrubs at home versus at the hospital on the bacterial contamination at the beginning of a scheduled shift.

METHODS

This was a single blind randomized controlled trial. Eligible participants were resident physicians assigned to labor and delivery at a single institution during the study period, and participants were randomized daily to 1 of 4 arms based on the site where their scrubs were laundered (A) and where the resident dressed (B) (A/B): home/home, home/hospital, hospital/home, and hospital/hospital. At the beginning of the assigned shift, microbiologic samples from the chest pocket and pants' tie were collected with a sterile culture swab. Samples were plated on trypticase soy agar with 5% sheep blood before being incubated at 35°C-37°C for 48 hours, with observation every 24 hours. The primary outcome was total bacterial burden, defined as the sum of the colony forming units (CFUs) from the 2 sampling sites.

RESULTS

There were 21 residents randomized daily for 4 days to 1 of 4 study arms, resulting in 84 observations. There were no baseline differences between the home- and hospital-dressed cohorts. Overall, 68% of sampled scrubs demonstrated some bacterial growth. There was no difference between the home- and hospital-dressed cohorts in percentage of samples demonstrating any bacterial growth after 72 hours (60% vs 76%, P = .14), nor in median bacterial burden at the beginning of a shift (2 [interquartile range, 0-7] vs 1 [interquartile range, 1-5] CFUs, P = .62). Finally, there was no difference in total bacterial burden at the beginning of a shift between the home- and hospital-dressed cohorts when stratified by site where the scrubs were laundered.

CONCLUSIONS

There was no significant difference in total bacterial burden of surgical scrubs at the start of a shift between cohorts who dressed at home versus at the hospital.