This is not the first study showing physician white coats and nursing uniforms are colonized with bacteria, nor that may of those bacteria are pathogenic and multi-drug resistant. In the past, this has been used as a call for the abolishment of physician white coats, ties, and all long-sleeved apparel.
This study, however, shows that short-sleeved nursing uniforms were just as likely to be coated with bacteria – 49% to 54%. Interestingly, even “changing uniform daily” still resulted in colonization with pathogenic bacteria. The authors speculate the main issues are that all textiles easily transmit bacteria, and that hand hygiene might be more critical than uniforms in prevent transmission from patients to physician clothing.
This study also, like the many before it, doesn’t demonstrate anything but colonization – not documented patient-to-patient transmission via healthcare worker clothing or any specific outcome measures. However, I am a believer that white coats are fomites and medical relics that should go the way of bloodletting and golden elixirs. The studies in support of white coats cite patient satisfaction and ease of identification of roles – which, while important, could be mitigated by new interventions for identification of healthcare providers. Even though we yet have no evidence of harms from this colonization with pathogenic bacteria, it’s essentially a zero-cost intervention to stop wearing white coats and ties – so even if the number needed to treat to prevent a transmissible infection is immense, it’s a free way to protect our patients as best we can.
“Nursing and Physician Attire as Possible Source of Nosocomial Infections.”
www.ncbi.nlm.nih.gov/pubmed/21864762
Not just free – think of the savings in ties!
This is probably not enough to put the tie makers out of business, but there is also the enhanced protection of the fashion conscious from the assault of the hideous ties. đŸ˜‰