COMPARISON OF DECONTAMINATION BY CONVENTIONAL DOMESTIC WASH VERSUS CHEMICAL WASH OF HEALTH PROFESSIONAL UNIFORMS AND ITS RELATIONSHIP WITH FREQUENCY OF MICROORGANISMS ON THEIR UNIFORMS
Main Article Content
Keywords
Microbial Contamination, Health Care Professionals, Conventional Domestic Wash, Chemical Decontamination
Abstract
Background: Healthcare organizations prioritize infection control to ensure a safe, and infection-free environment for patients. The spread of pathogens from hospitals by health care professionals’ uniforms and kits, as well as the efficacy of domestic laundering of health professionals’ uniforms, are still major concerns.
Objectives: To assess the frequency of microorganisms on the uniforms of health care professionals and to compare the decontamination efficacy of conventional domestic washing with germicidal chemical disinfection.
Methodology: The study utilized a randomized control trial design and a systematic random sampling technique to analyze data from 32 healthcare professionals (doctors and nurses) working in Shaikh Zayed Hospital in Lahore. The collected information was analyzed using the Statistical Package for the Social Sciences (SPSS) version 25. The mean and standard deviation were calculated for the bacterial count on health professional uniforms. Frequency and percentage were given for the categorical variable. A Chi-Square test was used to compare disinfection frequency between the interventional and control groups, with a significance level of P-value ≤ 0.05.
Result: The result of the study revealed that microorganisms were found on 32 (50%) uniforms before washing, of which 17 (53%) were from the control group and 15 (47%) were from the interventional group. After washing the uniform with detergent and 3%-H2O2 only 06 (19%) uniforms were positive for microorganisms. The following microorganisms were observed: Staphylococcus Aureus strains, Proteus Mirabilis, E-Coli, Streptococcus, and Klebsiella.
Conclusion: The domestic wash technique was less effective in reducing microorganisms from health professionals’ uniforms than chemical wash, as chemical wash can completely remove all types of microorganisms. However, it is also identified that about 78% of S. aureus strains were isolated from the positive cases.
References
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43. Stanczak, A. 2018. Reactive Oxygen Species in Laundry Applications. Durham University.
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45. Thom, K. A., Escobar, D., Boutin, M. A., Zhan, M., Harris, A. D. & Johnson, J. K. 2018. Frequent contamination of nursing scrubs is associated with specific care activities. American journal of infection control, 46(5): 503-506.
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47. Vera, C. M. 2016. Laundering Methods for Reusable Surgical Scrubs: A Literature Review. AANA journal, 84(4).
48. Vikke, H. S. & Giebner, M. 2015. UniStatus-a cross-sectional study on the contamination of uniforms in the Danish ambulance service. BMC research notes, 81-6.
49. Wiener-Well, Y., Galuty, M., Rudensky, B., Schlesinger, Y., Attias, D. & Yinnon, A. M. 2011. Nursing and physician attire as possible source of nosocomial infections. American journal of infection control, 39(7): 555-559.
50. Wright, S. N., Gerry, J. S., Busowski, M. T., Klochko, A. Y., Mcnulty, S. G., Brown, S. A., Sieger, B. E., Michaels, P. K. & Wallace, M. R. 2012. Gordonia bronchialis sternal wound infection in 3 patients following open heart surgery: intraoperative transmission from a healthcare worker. Infection Control & Hospital Epidemiology, 33(12): 1238-1241.
51. Zaib, H., Kanwar, R., Zafar, N. & Ali, S. 2019. Prevalence and multidrug resistance profiles of several bacterial pathogens isolated from hospital inanimate surfaces in Faisalabad, Pakistan. Novel Research in Microbiology Journal, 3(6): 526-534.
2. Andersen, B. M. & Andersen, B. M. 2019. Staff Uniforms and Uniform Policy. Prevention and Control of Infections in Hospitals: Practice and Theory, 65-70.
3. Bockmühl, D. P., Schages, J. & Rehberg, L. 2019. Laundry and textile hygiene in healthcare and beyond. Microbial Cell, 6(7): 299.
4. Books, H. 2013. Control of substances hazardous to health.
5. Byrns, G., Barham, B., Yang, L., Webster, K., Rutherford, G., Steiner, G., Petras, D. & Scannell, M. 2017. The uses and limitations of a hand-held germicidal ultraviolet wand for surface disinfection. Journal of occupational and environmental hygiene, 14(10): 749-757.
6. Chiereghin, A., Felici, S., Gibertoni, D., Foschi, C., Turello, G., Piccirilli, G., Gabrielli, L., Clerici, P., Landini, M. P. & Lazzarotto, T. 2020. Microbial contamination of medical staff clothing during patient care activities: performance of decontamination of domestic versus industrial laundering procedures. Current Microbiology, 77(7): 1159-1166.
7. England, N. & Improvement, N. 2020. Uniforms and workwear: guidance for NHS employers. NHS England, London, United Kingdom.
8. Garrett Jr, J. H. 2015. A review of the CDC recommendations for prevention of HAIs in outpatient settings. AORN journal, 101(5): 519-528.
9. Gupta, P., Bairagi, N. & Gupta, D. 2019. Effect of Domestic Laundering on Removal of Bacterial Contamination from Nurses’ White Coats. Functional Textiles and Clothing. Springer.
10. Health, D. O. 2010. Uniforms and workwear: Guidance on uniform and work-wear policies for NHS employers. Department of Health London.
11. Hunt, J. & Campbell, D. 2013. Using a community development approach for Aboriginal development in Central Australia.
12. Indrei, L. L., Raftu, G., Debita, M. & Esanu, I. 2019. The role of chemical substances in the assessment of the hygenic and sanitary conditions from medical practices. Revista de chimie, 70(2).
13. Iqbal, S., Ahmed, S., Aslam, A., Kashif, M., Khan, I. & Khan, N. 2020. microbial flora on the white coats of dental staff, Karachi. IJEHSR [Internet]. 1Mar, 8(1): 21-7.
14. Jiang, T., Guo, Y., Feng, X., Sa, Y., Yang, X., Wang, M., Li, P. & Wang, Y. 2018. Hydrogen peroxide might bleach natural dentin by oxidizing phosphoprotein. Journal of Dental Research, 97(12): 1339-1345.
15. Kanwar, A., Cadnum, J. L., Thakur, M., Jencson, A. L. & Donskey, C. J. 2018. Contaminated clothing of methicillin-resistant Staphylococcus aureus (MRSA) carriers is a potential source of transmission. American Journal of Infection Control, 46(12): 1414-1416.
16. Khan, F., Ahmad, B., Ahmed, J., Yoo, H. S. & Bashir, S. 2018. Investigation of Staphylococcus aureus, prevailing in the environment of Khyber Teaching Hospital, Peshawar, Pakistan. Pakistan Journal of Pharmaceutical Sciences, 31(2).
17. Khattak, S. U., Bacha, N., Lutfullah, G., Bakht, J., Ali, S., Ali, J. & Khan, A. A. 2015. Study of the genetic traits associated with antibiotic resistance in Staphylococcus aureus isolated from skin wards of Khyber Pakhtunkhwa, Pakistan. Asian Pacific Journal of Tropical Disease, 5(5): 393-398.
18. Kimmel, T., Kunkel, C., Sghir, M. A., Pauels, K. & Kessler, A. 2022. Effect of the pre-treatment of stains with ultrasound in household laundry cleaning. Tenside Surfactants Detergents, 59(2): 168-175.
19. Laird, K. & Owen, L. 2020. The role of protective clothing in healthcare and its decontamination. Decontamination in hospitals and healthcare. Elsevier.
20. Laird, K., Riley, K. & Williams, J. 2018. Domestic laundering of nurses’ uniforms: what are the risks. Nursing Times [online], 114(2): 18-21.
21. Lena, P., Karageorgos, S. A., Loutsiou, P., Poupazi, A., Lamnisos, D., Papageorgis, P. & Tsioutis, C. 2021. Multidrug-Resistant Bacteria on Healthcare Workers’ Uniforms in Hospitals and Long-Term Care Facilities in Cyprus. Antibiotics, 11(1): 49.
22. Luo, X. 2021. Studies of chitosan/cotton blended fabric and its application on antimicrobial and wound healing acceleration.
23. Maal-Bared, R. 2019. Efficacy of laundering and tumble-drying in reducing microbial contamination of wastewater treatment plant worker coveralls. American Journal of Infection Control, 47(5): 527-533.
24. Maree, M., Thi Nguyen, L. T., Ohniwa, R. L., Higashide, M., Msadek, T. & Morikawa, K. 2022. Natural transformation allows transfer of SCC mec-mediated methicillin resistance in Staphylococcus aureus biofilms. Nature Communications, 13(1): 2477.
25. Moccia, G., Motta, O., Pironti, C., Proto, A., Capunzo, M. & De Caro, F. 2020. An alternative approach for the decontamination of hospital settings. Journal of Infection and Public Health, 13(12): 2038-2044.
26. Monteiro, A., Cardoso, J., Guerra, N., Ribeiro, E., Viegas, C., Cabo Verde, S. & Sousa-Uva, A. 2022. Exposure and health effects of bacteria in healthcare units: An overview. Applied Sciences, 12(4): 1958.
27. Munoz-Price, L. S., Arheart, K. L., Mills, J. P., Cleary, T., Depascale, D., Jimenez, A., Fajardo-Aquino, Y., Coro, G., Birnbach, D. J. & Lubarsky, D. A. 2012. Associations between bacterial contamination of health care workers' hands and contamination of white coats and scrubs. American journal of infection control, 40(9): e245-e248.
28. Mutombo, F. D. 2019. Chiropractic white coats as potential reservoirs for nosocomial pathogens. University of Johannesburg (South Africa).
29. Otter, J. A., Donskey, C., Yezli, S., Douthwaite, S., Goldenberg, S. & Weber, D. 2016. Transmission of SARS and MERS coronaviruses and influenza virus in healthcare settings: the possible role of dry surface contamination. Journal of hospital infection, 92(3): 235-250.
30. Owen, L. & Laird, K. 2020. The role of textiles as fomites in the healthcare environment: a review of the infection control risk. PeerJ, 8e9790.
31. Patel, S., Murray-Leonard, J. & Wilson, A. 2006. Laundering of hospital staff uniforms at home. Journal of Hospital Infection, 62(1): 89-93.
32. Pesce, S., Ghiglione, J.-F., Topp, E. & Martin-Laurent, F. 2020. Microbial Ecotoxicology. Frontiers in Microbiology, 1342.
33. Profetto-Mcgrath, J., Polit, D. F. & Beck, C. T. 2010. Canadian essentials of nursing research, Lippincott Williams & Wilkins.
34. Reynolds, K. A., Verhougstraete, M. P., Mena, K. D., Sattar, S. A., Scott, E. A. & Gerba, C. P. 2022. Quantifying pathogen infection risks from household laundry practices. Journal of Applied Microbiology, 132(2): 1435-1448.
35. Riley, K., Laird, K. & Williams, J. 2015. Washing uniforms at home: adherence to hospital policy. Nursing Standard (2014+), 29(25): 37.
36. Riley, K., Williams, J., Owen, L., Shen, J., Davies, A. & Laird, K. 2017. The effect of low‐temperature laundering and detergents on the survival of Escherichia coli and Staphylococcus aureus on textiles used in healthcare uniforms. Journal of Applied Microbiology, 123(1): 280-286.
37. Rutala, W. A. & Weber, D. J. 2016. Disinfection, sterilization, and antisepsis: An overview. American journal of infection control, 44(5): e1-e6.
38. Sarwar, S., Saleem, S., Shahzad, F. & Jahan, S. 2023. Identifying and elucidating the resistance of Staphylococcus aureus isolated from hospital environment to conventional disinfectants. American Journal of Infection Control, 51(2): 178-183.
39. Schmithausen, R. M., Sib, E., Exner, M., Hack, S., Rösing, C., Ciorba, P., Bierbaum, G., Savin, M., Bloomfield, S. F. & Kaase, M. 2019. The washing machine as a reservoir for transmission of extended-spectrum-beta-lactamase (CTX-M-15)-producing Klebsiella oxytoca ST201 to newborns. Applied and environmental microbiology, 85(22): e01435-19.
40. Sehulster, L. M. 2015. Healthcare laundry and textiles in the United States: review and commentary on contemporary infection prevention issues. Infection control & hospital epidemiology, 36(9): 1073-1088.
41. Shaheen, A. & Baqai, R. 2016. Biofilm Formation by Environmental Microbes Isolated from Hospitals in Karachi, Pakistan. American scientific research journal for engineering, technology, and sciences, 15(1): 240-251.
42. Shahsavari, S., Alavi, A., Razmjoue, P., Mohseni, S., Ranae, V., Hosseini, Z. & Dadipoor, S. 2022. A predictive model of genital warts preventive behaviors among women in the south of Iran: application of health belief model. BMC Women's Health, 22(1): 63.
43. Stanczak, A. 2018. Reactive Oxygen Species in Laundry Applications. Durham University.
44. Tarrant, J., Jenkins, R. O. & Laird, K. T. 2018. From ward to washer: The survival of Clostridium difficile spores on hospital bed sheets through a commercial UK NHS healthcare laundry process. Infection Control & Hospital Epidemiology, 39(12): 1406-1411.
45. Thom, K. A., Escobar, D., Boutin, M. A., Zhan, M., Harris, A. D. & Johnson, J. K. 2018. Frequent contamination of nursing scrubs is associated with specific care activities. American journal of infection control, 46(5): 503-506.
46. Torres, A. E., Lyons, A. B., Narla, S., Kohli, I., Parks-Miller, A., Ozog, D., Hamzavi, I. H. & Lim, H. W. 2020. Ultraviolet-C and other methods of decontamination of filtering facepiece N-95 respirators during the COVID-19 pandemic. Photochemical & Photobiological Sciences, 19746-751.
47. Vera, C. M. 2016. Laundering Methods for Reusable Surgical Scrubs: A Literature Review. AANA journal, 84(4).
48. Vikke, H. S. & Giebner, M. 2015. UniStatus-a cross-sectional study on the contamination of uniforms in the Danish ambulance service. BMC research notes, 81-6.
49. Wiener-Well, Y., Galuty, M., Rudensky, B., Schlesinger, Y., Attias, D. & Yinnon, A. M. 2011. Nursing and physician attire as possible source of nosocomial infections. American journal of infection control, 39(7): 555-559.
50. Wright, S. N., Gerry, J. S., Busowski, M. T., Klochko, A. Y., Mcnulty, S. G., Brown, S. A., Sieger, B. E., Michaels, P. K. & Wallace, M. R. 2012. Gordonia bronchialis sternal wound infection in 3 patients following open heart surgery: intraoperative transmission from a healthcare worker. Infection Control & Hospital Epidemiology, 33(12): 1238-1241.
51. Zaib, H., Kanwar, R., Zafar, N. & Ali, S. 2019. Prevalence and multidrug resistance profiles of several bacterial pathogens isolated from hospital inanimate surfaces in Faisalabad, Pakistan. Novel Research in Microbiology Journal, 3(6): 526-534.
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Jan 17, 2024
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Mr. Noor Ul Haq, Prof. Dr. Samina Kausar, Prof. Dr. Sidrah Saleem, & Waqas Latif. (2024). COMPARISON OF DECONTAMINATION BY CONVENTIONAL DOMESTIC WASH VERSUS CHEMICAL WASH OF HEALTH PROFESSIONAL UNIFORMS AND ITS RELATIONSHIP WITH FREQUENCY OF MICROORGANISMS ON THEIR UNIFORMS. Journal of Population Therapeutics and Clinical Pharmacology, 31(1), 792–812. https://doi.org/10.53555/jptcp.v31i1.4086
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Author Biographies
Mr. Noor Ul Haq
Phil. Scholar | University of Health Sciences, Lahore Pakistan.
Prof. Dr. Samina Kausar
Professor & Head of Nursing Department | University of Health Sciences, Lahore
Prof. Dr. Sidrah Saleem
Professor & Head of Microbiology Department | University of Health Sciences, Lahore
Waqas Latif
Biostatistician & Data Analyst | University of Health Sciences, Lahore Pakistan.