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

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

Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover design (BETR Disinfection)

“…The hands and clothing of health-care professionals regularly become contaminated by both the patient and the environment. 17–19…”

Impacts of silver-coated antimicrobial screen covers on the cell-phone microbiome of resident physicians

“…However, silver was ineffective in reducing bacterial viability in a previous culture-based study that revealed no significant difference in colony-forming units of bacteria found on silverimpregnated surgical scrubs compared to cotton scrubs worn by healthcare providers. 10 According to the manufacturer of the screens, the antimicrobial properties are due to leaching of silver ions from the glass. 4 Thus, another explanation for the observed lack of difference could be that effective doses of silver were no longer being leached from the glass, thus it lost its antimicrobial properties by day 30.…”

Medical textiles with silver/nanosilver and their potential application for the prevention and control of healthcare-associated infections – mini-review

“…However, little literature data are available concerning the effect of antimicrobial silvered/nanosilvered medical textiles in hospital settings in the aspect of the reduction of the prevalence of HAI-associated pathogens, and thus the reduction of HAI incidence. Of note, most articles were focused on their use in the hospital staff clothes to reduce their bacterial contamination and transmission [17][18][19][20].…”

“…In the data obtained during the Antimicrobial Scrub Contamination and Transmission (ASCOT) trial [20], antimicrobial-impregnated scrubs, including silver-containing cloths, were not effective at reducing bacterial contamination as compared to traditional cloths measured as the sum of colony-forming units (CFU) of bacteria identified on nurse scrubs from each clothing location. These studies enrolled nurses from medical and surgery intensive care units of the university hospital, and samples for microbiological analysis were collected during 3 consecutive 12-hour shifts in the intensive care unit.…”