Study: Antimicrobial Scrubs Do Not Prevent Contamination

By on 10:25 AM

A new study shows that wearing scrubs with antimicrobial properties is ineffective at preventing bacterial contamination.

For the study, Duke University Hospital researchers followed 40 nurses wearing three different types of scrubs — 1) traditional cotton-polyester scrubs; 2) scrubs with embedded silver-alloy; and 3) scrub treated with a combination of antibacterial materials — over three consecutive shifts. Researchers took a series of cultures from each nurse, the healthcare environment, and patients during each shift.

Analyses of nearly 3,000 cultures from the environment (bed rails, beds and supply carts in each room) and nearly 2,200 from the nurses' scrubs (sleeve, abdomen and pocket) revealed that scrub type was not associated with a change in clothing contamination.

The study is titled "The Antimicrobial Scrub Contamination and Transmission (ASCOT) Trial: A Three-Arm, Blinded, Randomized Controlled Trial With Crossover Design to Determine the Efficacy of Antimicrobial-Impregnated Scrubs in Preventing Healthcare Provider Contamination." It appeared in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA).

"There is no such thing as a sterile environment," said Deverick Anderson, MD, MPH, director of the Center for Antimicrobial Stewardship and Infection Prevention at Duke University Medical Center and lead author of the study, according to a SHEA news release. "Bacteria and pathogens will always be in the environment. Hospitals need to create and use protocols for improved cleaning of the healthcare environment, and patients and family members should feel empowered to ask healthcare providers if they are doing everything they can to keep their loved one from being exposed to bacteria in the environment."

The authors offered the following key takeaways from the study:
  • Scrubs were likely ineffective at reducing pathogens because of low-level disinfectant capabilities of the textiles and repeated exposure in a short timeframe.
  • Antimicrobial-impregnated textiles might be effective if used in bed linens and patient gowns.
  • Diligent hand hygiene is recommended following all patient room entries and exits.
  • When appropriate, use of gowns and gloves is recommended to reduce risk of clothing contamination, even if no direct patient care is performed.
Infection Control Consulting Services urges facilities to empower their clinical staff to follow nationally recognized guidelines and standards. These include the Centers for Disease Control and Prevention's (CDC) 2007 "Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings." Within the guideline is a section relating to standard precautions which highlights the need to protect clothing when encountering or anticipating encountering blood and body fluids or other sources that could potentially contaminate healthcare workers' clothing.

Phenelle Segal, RN, CIC, FAPIC

Phenelle Segal, RN, CIC, FAPIC, is the founder and president of Infection Control Consulting Services LLC (ICCS). Phenelle has more than 30 years' experience providing customized comprehensive infection control and prevention services to healthcare facilities nationwide. Her services focus on assisting hospitals, ambulatory surgery centers, dental office and oral surgery practices, doctor's offices, nursing homes and other organizations with implementing and maintaining an infection control program that: complies with The Joint Commission, AAAHC, Centers for Medicaid and Medicare Services (CMS) and other regulatory agencies; respond to situations of noncompliance; and improve the processes for reducing risk.