Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.
Department of Medicine, University of Maryland Medical Center, Baltimore, MD.
Am J Infect Control. 2018 May;46(5):503-506. doi: 10.1016/j.ajic.2017.11.016. Epub 2018 Jan 11.
The objective of this article is to assess health care worker (HCW) and patient care factors associated with bacterial contamination of scrubs.
We performed a cohort study of critical care HCWs. Participants were given 4 sets of new scrubs; each set was sampled 8 times during the 8-month study period on random days in the last 4 hours of the shift. Total colony counts and presence of prespecified pathogenic bacteria were assessed. Generalized estimating equation was used to identify factors associated with contamination.
There were 720 samples obtained from 90 HCWs; 30% of samples were contaminated with pathogenic bacteria. Multivariate analysis showed that providing care for patients with wounds (odds ratio [OR], 1.75; 95% confidence interval [CI], 1.17-2.62; P < .01) or giving a bath (OR, 1.46; 95% CI, 0.96-2.22; P = .07) was associated with higher odds of scrub contamination. A second model showed the average log colony count of bacterial contamination of scrubs was higher when a bath was given (log colony count difference, 0.21; P = .05) but lower among HCWs assigned to care for at least 1 patient on contact precautions (log colony count difference, 0.28; P < .01).
HCW attire was frequently contaminated with bacteria. Providing care for patients with wounds or giving a bath were associated with scrub contamination by pathogenic bacteria. However, the amount of contamination was lower among HCWs who were assigned to care for patients on contact precautions.
本文旨在评估与刷手服细菌污染相关的医护人员(HCW)和患者护理因素。
我们对重症监护病房的 HCW 进行了队列研究。参与者每人发放 4 套全新的刷手服;在 8 个月的研究期间,在轮班最后 4 小时的随机日子里,每 8 次对每套刷手服进行 8 次采样。评估总菌落计数和特定致病性细菌的存在情况。使用广义估计方程来确定与污染相关的因素。
从 90 名 HCW 中获得了 720 个样本;30%的样本受到了致病性细菌的污染。多变量分析表明,为有伤口的患者提供护理(比值比[OR],1.75;95%置信区间[CI],1.17-2.62;P<.01)或洗澡(OR,1.46;95% CI,0.96-2.22;P=.07)与刷手服污染的几率更高相关。第二个模型显示,当进行洗澡时,刷手服的细菌污染平均对数菌落数更高(菌落数差异,0.21;P=.05),但在接触预防措施下至少负责 1 名患者的 HCW 中,污染程度较低(菌落数差异,0.28;P<.01)。
HCW 的服装经常受到细菌污染。为有伤口的患者提供护理或洗澡与刷手服被致病性细菌污染相关。然而,在被分配照顾接触预防措施下的患者的 HCW 中,污染程度较低。