医护人员白大褂的细菌污染

David

American Journal of Infection Control
Volume 37, Issue 2, March 2009, Pages 101-105
Hemodynamic Monitoring in the Diagnosis and Management of Heart Failure

Major Article Bacterial contamination of health care workers' white coats
医护人员白大褂的细菌污染

Amy M. Treakle MDa, Kerri A. Thom MDb, Jon P. Furuno PhDb, Sandra M. Strauss BS M(ASCP)b, Anthony D. Harris MD, MPHb and Eli N. Perencevich MD, MSc,

                               
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,

                               
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aDepartment of Medicine, University of Maryland Medical Center, Baltimore, MD
bDepartment of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
cVA Maryland Health Care System, Baltimore, MD


Available online 3 October 2008.


BackgroundPatient-to-patient transmission of nosocomial pathogens has been linked to transient colonization of health care workers, and studies have suggested that contamination of health care workers' clothing, including white coats, may be a vector for this transmission.
MethodsWe performed a cross-sectional study involving attendees of medical and surgical grand rounds at a large teaching hospital to investigate the prevalence of contamination of white coats with important nosocomial pathogens, such as methicillin-sensitive Stapylococcus aureus, methicillin-resistant S aureus (MRSA), and vancomycin-resistant enterococci (VRE). Each participant completed a brief survey and cultured his or her white coat using a moistened culture swab on lapels, pockets, and cuffs.
ResultsAmong the 149 grand rounds attendees' white coats, 34 (23%) were contaminated with S aureus, of which 6 (18%) were MRSA. None of the coats was contaminated with VRE. S aureus contamination was more prevalent in residents, those working in inpatient settings, and those who saw an inpatient that day.
ConclusionThis study suggests that a large proportion of health care workers' white coats may be contaminated with S aureus, including MRSA. White coats may be an important vector for patient-to-patient transmission of S aureus.

控制感染

您好David 老师!
     "医护人员白大褂的细菌污染"现在我们太需要这方面的材料了.但很遗憾看不懂啊!请帮忙吧.:handshake

MZYGMAYING

顶一个,看不懂,但是的确 非常需要

怡之秋

是的，需要这样强有力的资料。。。谢谢分享，问好。

shanesteven

American Journal of Infection Control美国感控杂志Volume 37, Issue 2, March 2009, Pages 101-105Hemodynamic Monitoring in the Diagnosis and Management of Heart Failure
心力衰竭的血流动力学的管理与诊断Major Article Bacterial contamination of health care workers' white coats医护人员白大褂的细菌污染Amy M. Treakle MDa, Kerri A. Thom MDb, Jon P. Furuno PhDb, Sandra M. Strauss BS M(ASCP)b, Anthony D. Harris MD, MPHb and Eli N. Perencevich MD, MSc, , aDepartment of Medicine, University of Maryland Medical Center, Baltimore, MDbDepartment of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MDcVA Maryland Health Care System, Baltimore, MDAvailable online 3 October 2008.Background：Patient-to-patient transmission of nosocomial pathogens has been linked to transient colonization of health care workers, and studies have suggested that contamination of health care workers' clothing, including white coats, may be a vector for this transmission.
背景：病人之间的医院病原体传播与医务工作者携带细菌的短期定植有关，研究建议医务工作者的衣服污染，包括白大褂，可能是病菌传播的途径。
Methods：We performed a cross-sectional study involving attendees of medical and surgical grand rounds at a large teaching hospital to investigate the prevalence of contamination of white coats with important nosocomial pathogens, such as methicillin-sensitive Stapylococcus aureus, methicillin-resistant S aureus (MRSA), and vancomycin-resistant enterococci (VRE). Each participant completed a brief survey and cultured his or her white coat using a moistened culture swab on lapels, pockets, and cuffs.
方法：我们进行横断面研究，涉及在大型教学医院的医疗和手术的大查房参加调查的白大褂污染具有重要的院内感染的病原体，如甲氧西林敏感的Stapy lococcus金黄色葡萄球菌，耐甲氧西林金黄色葡萄球菌（MRSA）的患病率，和耐万古霉素肠球菌（VRE）。每名参加者完成一个简短的调查并且改变了他或她的白大衣，翻领，口袋，袖口的湿化情况。

ResultsAmong the 149 grand rounds attendees' white coats, 34 (23%) were contaminated with S aureus, of which 6 (18%) were MRSA. None of the coats was contaminated with VRE. S aureus contamination was more prevalent in residents, those working in inpatient settings, and those who saw an inpatient that day.
结果：在149大查房出席者者的白大衣中，34（23％），金黄色葡萄球菌，其中有6个（18％）被葡萄球菌污染。抗万古霉素肠球菌的大衣没有被污染。金黄色葡萄球菌污染的居民，在住院部工作，和那些他们见一天病人的尤为明显。
ConclusionThis study suggests that a large proportion of health care workers' white coats may be contaminated with S aureus, including MRSA. White coats may be an important vector for patient-to-patient transmission of S aureus.
结论：这项研究表明，大比例的医护人员的白大褂，可能与金黄色葡萄球菌，包括MRSA污染。白大衣，可为病人门诊金黄色葡萄球菌的传播的重要载体。

蓝鱼o_0

HCW uniforms contaminated with potentially pathogenic bacteria

潜在致病微生物污染医护人员制服

Wiener-Well Y. Am J Infect Control. 2011;39:555-559.

Approximately 60% of health care worker uniforms sampled were colonized with potentially pathogenic bacteria that included drug-resistant organisms,
最新的研究显示，医护人员的制服60%可以定植潜在的致病原，包括耐药菌。
according to new findings published in the American Journal of Infection Control.
Although 58% of participants said they changed their uniform daily
58%的医护人员每天更换制服，但77%的人认为他们制服的清洁水平非常好。
and 77% described their attire’s hygiene level as “fair to excellent,” Yonit Wiener-Well, MD, of the infectious disease unit at Shaare Zedek Medical Center in Jerusalem, and colleagues isolated potentially pathogenic bacteria from at least one site on 63% of participants’ uniforms.

“We believe the data suffice to formulate recommendations regarding health care worker (HCW) uniforms,” Wiener-Well told Infectious Disease News. “Professional organizations may issue guidelines about wearing a clean uniform daily, providing adequate laundering, improving hand hygiene practices and using plastic aprons when performing tasks that may involve splashing or contact with body fluids, which are likely to decrease the bacterial load on uniforms. Wearing short-sleeved coats or even having physicians discard their white coats could further reduce the cloth-borne transmission of pathogens.”
【指南要求】每天更换制服，提供充分的清洗，促进手卫生和穿戴塑料围裙（在器械清洗中）等操作可能降低布源性病原体的传播。
【研究改进】穿着短袖的外套，甚至有医生丢弃自己的白大褂，可能进一步降低布源性病原体的传播。
【SAMPLE SIZE】
Swab samples were collected (n=238) from the abdominal zone（腹部分离的样本238份）, sleeve ends and pockets of registered nurse (n=75) （袖口和口袋75份）and physician uniforms (n=60) （内科医生制服60套）at a 550-bed university-affiliated hospital. Participants were asked to complete a questionnaire.
Half of all samples tested positive for pathogenic organisms; 11% were multidrug-resistant.
50%的样本检测出致病原，11%为MDRO。
In addition, bacteria were isolated from 21 samples removed from nurses’ gowns and six samples removed from physicians’ gowns — including eight cultures that grew methicillin-resistant Staphylococcus aureus.
“Our work should preferably be repeated in larger studies, including physicians and nurses from all departments, which may be more representative,” Wiener-Well said. “Further studies can be designed to determine whether bacteria from HCW uniforms are transmitted to patients.” – by Ashley DeNyse

马晓荔

backgroundpatient-to-patient院内传播的病原体已链接到瞬态殖民卫生保健工作者，和研究表明，污染的卫生保健工作者的服装，包括白色外套，可能是一个向量的这一传输。方法：进行了一项横断面研究涉及的医疗和手术大发在一个大型教学医院调查的流行污染的白色外套与重要的院内感染的病原体，如金黄色葡萄球菌甲氧西林敏感的葡萄球菌属，耐甲氧西林金黄色葡萄球菌（葡萄球菌），和耐万古霉素肠球菌（万古霉素耐药菌）。每个参与者完成了简短的调查和培养他或她的白大衣使用润湿文化拭子在衣领，口袋，袖口。结果149大查房与会者的白色外套，34（23%）被污染的金黄色葡萄球菌，其中6（18%）是葡萄球菌。没有被污染的万古霉素耐药菌的大衣。金黄色葡萄球菌污染较普遍的居民，这些工作在住院的设置，和那些谁看到一个住院的那天。结论本研究表明，很大比例的卫生保健工作者'白大衣可能含有金黄色葡萄球菌，包括耐甲氧西林金黄色葡萄球菌。白大衣可能是一个重要载体的病人与病人传播的金黄色葡萄球菌。

马晓荔

白大褂确实是院内感染的重要传播途径，但在规范中没有看到有关这方面的要求，请教各位老师，有什么管理制度和措施，上传供大家借鉴，谢谢！

月光依旧

这是我们管理医院医务人员着装的有利证据了。谢谢老师。

蓝鱼o_0

月光依旧 发表于 2011-9-9 09:59

                               
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这是我们管理医院医务人员着装的有利证据了。谢谢老师。

值得注意的是，里面强调了，衣服的清洗和更换。
选用合适的消毒剂进行织物消毒。
更换的频率，推荐是每天更换。

这些都是可以降低HCAI重要的措施需要引起关注。

Yubl

马晓荔 发表于 2011-9-9 09:48

                               
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backgroundpatient-to-patient院内传播的病原体已链接到瞬态殖民卫生保健工作者，和研究表明，污染的卫生保 ...

谢谢您的调查，我们只知道白大衣可能是污染源，但缺乏依据，您给提供了证据，有说服了，感谢啦！

ynosmile

下载学习了，为我们工作提供了科学依据，但是每天更换工作服，全院都做到不易。

冰上芭蕾

谢谢！很好的资料。学习了。可是实行起来很难啊，那得多少钱?

四叶草

蓝鱼o_0 发表于 2011-9-9 10:00

                               
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值得注意的是，里面强调了，衣服的清洗和更换。
选用合适的消毒剂进行织物消毒。
更换的频率，推荐是每 ...

每天更换工作服可能在一般的医院有的难度，我院平常是每周更换一次，夏天每周更换两次。

空紫

很想要的资料，谢谢了！！！

houyinchun

天天学习的话，我相信过不了多久专业英语水平暴涨！   -------看不懂啊！

dengmingqiong

文盲哈，看不懂啊！我们也是每周换一次，我想大多数医院也可能都是每周换一次吧，争取每周两次看行不

论坛好老师

我认为白大褂就像我们的手卫生一样，是造成院内感染的重要环节之一，但目前对白大褂的清洗消毒方法、更换时间、保存保管要求等无规范的要求或指引，希望这篇文章有一个系统的全文翻译，为我们的工作提供知道和依据。

小港弯

做起来难，现在我院是每周两次。

紫色的云儿

都知道白大衣上面细菌很多，可是天天洗，真的不大容易做到，我们也是每周冬天一次，夏天2次