Nurses’ uniforms harbour antibiotic-resistant bugs, study reveals

Scrubs worn by intensive care nurses can harbour antibiotic-resistant superbugs, according to a US study.

Researchers from Duke University School of Medicine in North Carolina who tested the uniforms of ICU nurses found bacteria including methicillin-resistant Staphylococcus aureus – more commonly known as MRSA – as well as Klebsiella pneumoniae and Pseudomonas aeruginosa, both of which can lead to pneumonia and other types of lung damage.

The team set out to understand how pathogens travel between the ‘transmission triangle’: patients, the environment where care is administered and the healthcare professional.

Specifically, they searched for five pathogens known to cause difficult-to-treat infections, such as MRSA, which can be transferred between patients or infect the nurses themselves.

Samples

The researchers took samples from the sleeves, pockets and midriffs of scrubs worn by 40 ICU nurses at the start and end of three 12-hour shifts at Duke University Hospital. 

Cultures were also collected from 167 of the patients the nurses had cared for during each shift and from the patients’ room contents, including the bed and bedrails.

The researchers confirmed 12 instances when at least one of the five pathogens had been transmitted from a patient or a patient’s room to a nurse’s scrubs.

Pockets and sleeves of the scrubs, and bed rails in the rooms, were most likely to be contaminated.

Transmission

Six incidents involved transmission from a patient to a nurse or a room to a nurse. An additional 10 transmissions were from a patient to a room.

The researchers did not document any nurse-to-patient or nurse-to-room transmission.

Study lead Deverick Anderson said the research emphasises the need for good hygiene.

‘Sometimes, there is a misconception that if a nurse is talking to patients but not touching them, it might be okay to skip protocols that help reduce pathogen transmission, such as washing hands or wearing gloves,’ he said.

‘The study’s results demonstrate the need for caution whenever healthcare providers enter a patient’s room, regardless of the task they are completing.’

Interactions

Public Health England estimates that about 300,000 patients a year in England acquire a healthcare-associated infection as a result of NHS care.

Dr Anderson said the study is significant because previous research on pathogen transmission focused on patient-to-nurse interactions, while this study demonstrates that patients’ rooms should be given equal consideration.

‘When dealing with very sick patients, healthcare personnel may feel a conflict between providing care and following protocol that helps prevent pathogen transmission,’ he said.

‘Our study shows following prevention strategies has to be a top priority.’