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The Antimicrobial Scrub Contamination and Transmission (ASCOT) Trial: A Three-Arm, Blinded, Randomized Controlled Trial With Crossover Design to Determine the Efficacy of Antimicrobial-Impregnated Scrubs in Preventing Healthcare Provider Contamination

  • Deverick J. Anderson (a1), Rachel Addison (a1), Yuliya Lokhnygina (a2), Bobby Warren (a3), Batu Sharma-Kuinkel (a3), Laura J. Rojas (a4), Susan D. Rudin (a5), Sarah S. Lewis (a1), Rebekah W. Moehring (a1) (a6), David J. Weber (a7), William A. Rutala (a7), Robert A. Bonomo (a4) (a5), Vance G. Fowler (a3), Daniel J. Sexton (a1) and the CDC Prevention Epicenters Program...

Abstract

OBJECTIVE

To determine whether antimicrobial-impregnated textiles decrease the acquisition of pathogens by healthcare provider (HCP) clothing.

DESIGN

We completed a 3-arm randomized controlled trial to test the efficacy of 2 types of antimicrobial-impregnated clothing compared to standard HCP clothing. Cultures were obtained from each nurse participant, the healthcare environment, and patients during each shift. The primary outcome was the change in total contamination on nurse scrubs, measured as the sum of colony-forming units (CFU) of bacteria.

PARTICIPANTS AND SETTING

Nurses working in medical and surgical ICUs in a 936-bed tertiary-care hospital.

INTERVENTION

Nurse subjects wore standard cotton-polyester surgical scrubs (control), scrubs that contained a complex element compound with a silver-alloy embedded in its fibers (Scrub 1), or scrubs impregnated with an organosilane-based quaternary ammonium and a hydrophobic fluoroacrylate copolymer emulsion (Scrub 2). Nurse participants were blinded to scrub type and randomly participated in all 3 arms during 3 consecutive 12-hour shifts in the intensive care unit.

RESULTS

In total, 40 nurses were enrolled and completed 3 shifts. Analyses of 2,919 cultures from the environment and 2,185 from HCP clothing showed that scrub type was not associated with a change in HCP clothing contamination (P=.70). Mean difference estimates were 0.118 for the Scrub 1 arm (95% confidence interval [CI], −0.206 to 0.441; P=.48) and 0.009 for the Scrub 2 rm (95% CI, −0.323 to 0.342; P=.96) compared to the control. HCP became newly contaminated with important pathogens during 19 of the 120 shifts (16%).

CONCLUSIONS

Antimicrobial-impregnated scrubs were not effective at reducing HCP contamination. However, the environment is an important source of HCP clothing contamination.

TRIAL REGISTRATION

Clinicaltrials.gov Identifier: NCT 02645214

Infect Control Hosp Epidemiol 2017;38:1147–1154

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Copyright

Corresponding author

Address correspondence to Deverick J. Anderson, MD, MPH, Associate Professor of Medicine, DUMC Box 102359, Durham, NC 27710 (Deverick.anderson@duke.edu).

Footnotes

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PREVIOUS PRESENTATION. A portion of these data were presented at IDWeek 2016 in New Orleans, Louisiana, on October 28, 2016.

Footnotes

References

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1. Magill, SS, Edwards, JR, Bamberg, W, et al. Multistate point-prevalence survey of health care-associated infections. New Engl J Med 2014;370:11981208.
2. Anderson, DJ, Chen, LF, Weber, DJ, et al. Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study. Lancet 2017;389:805814.
3. Rutala, WA, Gergen, MF, Sickbert-Bennett, EE, Williams, DA, Weber, DJ. Effectiveness of improved hydrogen peroxide in decontaminating privacy curtains contaminated with multidrug-resistant pathogens. Am J Infect Control 2014;42:426428.
4. Mitchell, BG, Dancer, SJ, Anderson, M, Dehn, E. Risk of organism acquisition from prior room occupants: a systematic review and meta-analysis. J Hosp Infect 2015;91:211217.
5. Burden, M, Cervantes, L, Weed, D, Keniston, A, Price, CS, Albert, RK. Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8-hour workday: a randomized controlled trial. J Hosp Med 2011;6:177182.
6. Treakle, AM, Thom, KA, Furuno, JP, Strauss, SM, Harris, AD, Perencevich, EN. Bacterial contamination of health care workers’ white coats. Am J Infect Control 2009;37:101105.
7. Loh, W, Ng, VV, Holton, J. Bacterial flora on the white coats of medical students. J Hosp Infect 2000;45:6568.
8. Abdel-Mohsen, AM, Abdel-Rahman, RM, Hrdina, R, Imramovsky, A, Burgert, L, Aly, AS. Antibacterial cotton fabrics treated with core-shell nanoparticles. Internat J Biol Macromolecules 2012;50:12451253.
9. Borkow, G, Zhou, SS, Page, T, Gabbay, J. A novel anti-influenza copper oxide containing respiratory face mask. PloS One 2010;5:e11295.
10. Mariscal, A, Lopez-Gigosos, RM, Carnero-Varo, M, Fernandez-Crehuet, J. Antimicrobial effect of medical textiles containing bioactive fibres. Eur J Clin Microbiol Infect Dis 2011;30:227232.
11. Schweizer, M, Graham, M, Ohl, M, Heilmann, K, Boyken, L, Diekema, D. Novel hospital curtains with antimicrobial properties: a randomized, controlled trial. Infect Control Hosp Epidemiol 2012;33:10811085.
12. Bearman, GM, Rosato, A, Elam, K, et al. A crossover trial of antimicrobial scrubs to reduce methicillin-resistant Staphylococcus aureus burden on healthcare worker apparel. Infect Control Hosp Epidemiol 2012;33:268275.
13. Burden, M, Keniston, A, Frank, MG, et al. Bacterial contamination of healthcare workers’ uniforms: a randomized controlled trial of antimicrobial scrubs. J Hosp Med 2013;8:380385.
14. Gross, R, Hubner, N, Assadian, O, Jibson, B, Kramer, A. Pilot study on the microbial contamination of conventional vs. silver-impregnated uniforms worn by ambulance personnel during one week of emergency medical service. GMS Krankenhaushygiene interdisziplinar 2010;5(2). doi: 10.3205/dgkh000152.
15. Boutin, MA, Thom, KA, Zhan, M, Johnson, JK. A randomized crossover trial to decrease bacterial contamination on hospital scrubs. Infect Control Hosp Epidemiol 2014;35:14111413.
16. Sharma-Kuinkel, BK, Rude, TH, Fowler, VG Jr. Pulse field gel electrophoresis. Methods Mol Biol 2016;1373:1171130.
17. Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control. 2007(35):S65S164.
18. Sifri, CD, Burke, GH, Enfield, KB. Reduced health care-associated infections in an acute care community hospital using a combination of self-disinfecting copper-impregnated composite hard surfaces and linens. Am J Infect Control 2016;44:15651571.
19. Rock, C, Thom, KA, Masnick, M, Johnson, JK, Harris, AD, Morgan, DJ. Frequency of Klebsiella pneumoniae carbapenemase (KPC)-producing and non-KPC-producing Klebsiella species contamination of healthcare workers and the environment. Infect Control Hosp Epidemiol 2014;35:426429.
20. Snyder, GM, Thom, KA, Furuno, JP, et al. Detection of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on the gowns and gloves of healthcare workers. Infect Control Hosp Epidemiol 2008;29:583589.
21. Perry, C, Marshall, R, Jones, E. Bacterial contamination of uniforms. J Hosp Infect 2001;48:238241.
22. Munoz-Price, LS, Arheart, KL, Mills, JP, et al. Associations between bacterial contamination of health care workers’ hands and contamination of white coats and scrubs. Am J Infect Control 2012;40:e245e248.
23. Morgan, DJ, Rogawski, E, Thom, KA, et al. Transfer of multidrug-resistant bacteria to healthcare workers’ gloves and gowns after patient contact increases with environmental contamination. Crit Care Med 2012;40:10451051.
24. Thom, KA, Johnson, JK, Lee, MS, Harris, AD. Environmental contamination because of multidrug-resistant Acinetobacter baumannii surrounding colonized or infected patients. Am J Infect Control 2011;39:711715.
25. Rutala, WA, Gergen, MF, Weber, DJ. Room decontamination with UV radiation. Infect Control Hosp Epidemiol 2010;31:10251029.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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