Studies tell us that nearly everything in the hospital environment can become a reservoir for pathogenic organisms. Fomites that can carry these pathogens include everything from computer keyboards, pens and phones, to identity badges and lanyards, stethoscopes, PDAs and other medical devices that are mobile and used from patient to patient without being cleaned in between uses.
One fomite that may be under the radar in some hospitals is healthcare fabric, whether it’s uniforms and scrubs, or patient bed linens, furniture and privacy curtains. For example, an item as ubiquitous as a fabric stethoscope cover has been found to be a troublesome fomite. Milam et al. (2001) studied how stethoscope covers are cared for and performed microbiological investigations on 22 covers collected over a three-week period. The researchers suggest that fabric stethoscope covers represent a potential infection control problem because they are used for prolonged periods, are infrequently laundered, and are contaminated with bacteria.
The survival of pathogenic organisms on fabrics found in the healthcare environment is becoming a bigger issue in the fight against healthcare-acquired infections (HAIs). A critical factor for the transmission of microorganisms from person to person or from the environment to a healthcare provider or a patient is the ability of the pathogen to survive on an environmental surface. Numerous studies indicate that bacteria can thrive on medical fabrics. Neely (2000) sought to determine the length of survival of various Gram-negative bacteria on fabrics and plastics commonly used in hospitals. Seven materials were tested: smooth cotton (clothing), cotton terry (towels), 60 percent cotton/40 percent polyester blend (scrub suits and lab coats), polyester (drapes), 75 percent nylon/25 percent spandex (pressure garments), polyvinyl (splash aprons), and polyurethane (keyboard covers). Neely used Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Serratia marcescens, Proteus mirabilis, Acinetobacter species, and Enterobacter species to inoculate material swatches and then assayed them at regular intervals. Survival was dependent on the bacterium, its inoculum size, and the material tested. At 102 microorganisms per swatch, bacteria survived from less than one hour to eight days. At 10(4) to 10(5) bacteria per swatch, survival ranged from two hours to more than 60 days. Neely says her findings emphasize the need for careful disinfection and conscientious contact control procedures in areas that serve immunosuppressed individuals.
