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Bacterial Contamination of Surgical Scrubs and Laundering Mechanisms: Infection Control Implications

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By Carolyn L. Twomey, RN, BSN; Heather Beitz, BA, MEd; and Helen Boehm Johnson, MD

 

Objective: To assess the bioburden associated with surgical scrub garments separated into eight categories based on single-use/re-usable status, use status (prior to use versus after use), and, for re-usable scrub garments, laundering mechanism (facility-laundered, third-party laundered and home-laundered). The study’s aim was to determine whether or not this information provided any insight into the safety and efficacy of re-usable versus single-use scrubs and laundering mechanism.

Study Design: Ten sets of surgical scrub garments, top and bottom, were collected from multiple healthcare organizations across the United States for each category (n=20) and evaluated using the Stomacher technique. The number of viable organisms on each garment was enumerated as colony-forming units (CFU) and the average log bacterial population and standard deviation associated with each garment was determined. The mean log10CFUs versus configuration were compared using a one-way analysis of variance (ANOVA).

Results: There was no statistically significant difference in mean microbial populations among the facility-laundered, third party-laundered or single-use scrubs, prior to use (“clean”). The mean microbial population associated with the home-laundered scrubs, prior to use (“clean”), however, was significantly greater than any of the other “clean” garment configurations. In fact, the mean microbial population associated with the home-laundered scrubs, prior to use (“clean”), was not significantly different from that of any of the after use (“worn”) garments.

Conclusion: Home-laundering is not as effective as facility or third-party laundering in decontaminating surgical scrub attire. Similarly, home-laundered scrubs are not as effectively “clean” as single-use scrubs prior to use. Further study is warranted to identify the bacterial organisms comprising the bioburden and their potential clinical impact, if any, on the development of surgical site infections and transmission of other healthcare-acquired infections (HAIs).

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