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Keywords:

  • MRSA;
  • methicillin-resistant Staphylococcus aureus;
  • uniform;
  • contamination;
  • white coat;
  • bare below the elbows

Abstract

BACKGROUND:

Governmental agencies in the United Kingdom and Scotland have recently instituted guidelines banning physicians' white coats and the wearing of long-sleeved garments to decrease nosocomial transmission of bacteria.

OBJECTIVE:

Our aim was to compare the degree of bacterial and methicillin-resistant Staphylococcus aureus contamination of physicians' white coats with that of newly laundered, standardized short-sleeved uniforms after an 8-hour workday and to determine the rate at which bacterial contamination of the uniform ensued.

DESIGN:

The design was a prospective, randomized controlled trial.

SETTING:

The setting was a university-affiliated public safety-net hospital.

PARTICIPANTS:

One hundred residents and hospitalists on an internal medicine service participated.

INTERVENTION:

Subjects wore either a physician's white coat or a newly laundered short-sleeved uniform.

MEASUREMENTS:

Bacterial colony count and the frequency with which methicillin-resistant Staphylococcus aureus was cultured from both garments over time were measured.

RESULTS:

No statistically significant differences were found in bacterial or methicillin-resistant Staphylococcus aureus contamination of physicians' white coats compared with newly laundered short-sleeved uniforms or in contamination of the skin at the wrists of physicians wearing either garment. Colony counts of newly laundered uniforms were essentially zero, but after 3 hours of wear they were nearly 50% of those counted at 8 hours.

CONCLUSIONS:

Bacterial contamination occurs within hours after donning newly laundered short-sleeved uniforms. After 8 hours of wear, no difference was observed in the degree of contamination of uniforms versus infrequently laundered white coats. Our data do not support discarding long-sleeved white coats for short-sleeved uniforms that are changed on a daily basis. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine.