Intravenous literature: Bearman, G.M.L., Rosato, A., Elam, K., Sanogo, K., Stevens, M.P., Sessler, C.N. and Wenzel, R.P. (2012) A Crossover Trial of Antimicrobial Scrubs to Reduce Methicillin-Resistant Staphylococcus aureus Burden on Healthcare Worker Apparel. Infection Control and Hospital Epidemiology. [epub ahead of print].
Background – The impact of antimicrobial scrubs on healthcare worker (HCW) bacterial burden is unknown.
Objective – To determine the effectiveness of antimicrobial scrubs on hand and apparel bacterial burden.Design.â€ƒProspective, crossover trial.
Setting and Participants – Thirty HCWs randomized to study versus control scrubs in an intensive care unit.
Methods – Weekly microbiology samples were obtained from scrub abdominal area, cargo pocket, and hands. Mean log colony-forming unit (CFU) counts were calculated. Compliance with hand hygiene practices was measured. Apparel and hand mean log CFU counts were compared.
Results – Adherence measures were 78% (910/1,173) for hand hygiene and 82% (223/273) for scrubs. Culture compliance was 67% (306/460). No differences were observed in bacterial hand burden or in HCWs with unique positive scrub cultures. No difference in vancomycin-resistant enterococci (VRE) and gram-negative rod (GNR) burden was observed. A difference in mean log methicillin-resistant Staphylococcus aureus (MRSA) CFU count was found between study and control scrubs for leg cargo pocket (mean log CFUs, 11.84 control scrub vs 6.71 study scrub; ), abdominal area (mean log CFUs, 11.35 control scrub vs 7.54 study scrub; ), leg cargo pocket at the beginning of shift (mean log CFUs, 11.96 control scrub vs 4.87 study scrub; ), and abdominal area pocket at the end of shift (mean log CFUs, 12.14 control scrubs vs 8.22 study scrub; ).
Conclusions – Study scrubs were associated with a 4â€“7 mean log reduction in MRSA burden but not VRE or GNRs. A prospective trial is needed to measure the impact of antimicrobial impregnated apparel on MRSA transmission rates.