Antimicrobial scrubs still susceptible to contamination, study says

Antimicrobial scrubs don’t provide greater protection from bacteria than traditional scrubs, according to a new study published in Infection Control & Hospital Epidemiology.

The Antimicrobial Scrub Contamination and Transmission Trial, conducted by researchers at Duke University Hospital, followed 40 nurses who wore three different types of scrubs over three consecutive 12-hour shifts. The researchers took a series of cultures from each nurse’s clothing, patients and the physical environment before and after each shift. The nurses rotated from traditional cotton-polyester scrubs to scrubs containing silver-alloy embedded in its fibers to scrubs treated with a number of antimicrobials.  

The nearly 3,000 cultures taken from bedrails, beds and supply carts in each room and the 2,185 cultures taken from the sleeves, abdomen and pockets of the nurses’ scrubs revealed no differences in contamination based on the types of scrubs worn.

“Health care providers must understand that they can become contaminated by their patients and the environment near patients,” says Deverick J. Anderson, M.D., MPH, director of the Center for Antimicrobial Stewardship and Infection Prevention at Duke University Medical Center and lead author of the study. “Although not effective, we looked to eliminate this risk for contamination by changing the material of nurses’ scrubs.”

Researchers identified new contamination during 33 percent of shifts, and found that scrubs became newly contaminated with bacteria during 16 percent of shifts. The most commonly transmitted pathogen was Staphylococcus aureus, including methicillin-resistant and -susceptible S. aureus.

The study’s authors say that it’s likely the scrubs with antimicrobial properties were ineffective at reducing pathogens because of the low-level disinfectant capabilities of the textiles combined with repeated exposure in a short time frame. However, they also note that antimicrobial-impregnated textiles might be more effective when used in bed linens and patient gowns.

The researchers say the study reinforces the importance of diligent hand-hygiene practices, and cleaning and disinfection procedures in hospitals to prevent health care-associated infections.

“There is no such thing as a sterile environment,” Anderson says. “Bacteria and pathogens will always be in the environment. Hospitals need to create and use protocols for improved cleaning of the health care environment, and patients and family members should feel empowered to ask health care providers if they are doing everything they can to keep their loved one from being exposed to bacteria in the environment.”

The research was supported by grants from the Centers for Disease Control and Prevention’s Prevention Epicenters Program, the National Center for Advancing Translational Sciences, National Institutes of Health and its National Institute of Allergy and Infectious Diseases.