Evaluation of the protective value of hospital gowns against blood strike-through and methicillin-resistant Staphylococcus aureus penetration

• Published in: American journal of infection control Vol. 26; no. 2; pp. 85 - 93
• Main Authors: Granzow, J.W., Smith, Jeffrey W., Nichols, Ronald Lee, Waterman, Ruth S., Muzik, Anita C.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: St. Louis, MO Mosby, Inc 01-04-1998; Mosby
• Subjects: Analysis of Variance; Bacillus subtilis - isolation & purification; Bacterial diseases; Biological and medical sciences; Blood-Borne Pathogens; Consumer Product Safety; Disposable Equipment; Equipment Reuse; Evaluation Studies as Topic; Human bacterial diseases; Humans; Infection Control - methods; Infectious Disease Transmission, Patient-to-Professional - prevention & control; Infectious diseases; Louisiana; Medical sciences; Methicillin Resistance; Occupational Exposure - prevention & control; Operating Rooms; Personnel, Hospital; Protective Clothing - microbiology; Skin Absorption; Spores; Staphylococcal Infections - prevention & control; Staphylococcal Infections - transmission; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus aureus - isolation & purification; Louisiana; Human; Contamination; Blood; Infection; Prevention; Efficiency; Bacteriosis; Bacteria; Micrococcales; Safety clothing; Micrococcaceae; Hospital; Staphylococcal infection; Comparative study; Staphylococcus aureus
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/S0196-6553(98)80027-8

Background: Hospital gowns protect patients and health care workers from exposure to blood and other infectious materials. Previous studies have shown that certain gowns do allow blood strike-through. Because of worldwide increases in the incidence of
Staphylococcus aureus infections, especially with methicillin-resistant strains, there is now increased concern regarding bacterial transmission through gowns.
Methods: This study evaluated six gown types used in hospitals (one disposable cover or isolation gown, three disposable operating room gowns, and new and washed reusable operating room gowns). Gowns were evaluated for dry spore and
S. aureus filtration efficiencies and were subjected to 20 time-pressure combinations with methicillin-resistant
S. aureus-spiked blood (10
4/ml) to evaluate blood strike-through and passage of methicillin-resistant
S. aureus.
Results: Blood strike-through was lowest with disposable operating room gowns 1 and 2 (polypropylene). Disposable operating room gown 3 (polyester-wood pulp) showed the greatest strike-through and overall passage of methicillin-resistant
S. aureus. Operating room gowns 1 and 2 showed minimal bacterial passage, whereas the disposable cover (polypropylene) only allowed passage at pressures greater than 1 psi. Bacterial filtration efficiency testing showed operating room gowns 1 and 2 to be the most protective; operating room gown 3 and both reusable (cotton) gowns were the least protective. Dry spore passage was greatest for reusable gowns.
Conclusion: Different hospital gowns offer varying degrees of protection against fluid strike-through or bacterial passage. Gowns therefore should be chosen according to the task performed and conditions encountered.