Q: How important are textiles such as doctor or nurse lab coats in transmitting disease?
Q: How does this importance weigh against the importance of sanitizing or disinfecting hard surfaces?
Question: How important are textiles such as doctor or nurse lab coats in transmitting disease?
Dr. Benjamin Tanner: Microbiologists understand that fomites (inanimate objects) can serve as transmission vehicles for microorganisms. Most disinfection and sanitization focuses on hard, non-porous surfaces such as tables, floors, and doorknobs, but it is well known that textiles are a surface of concern within the healthcare environment. Textiles tend to transmit fewer pathogens per touch than a similarly contaminated hard surface, but in my laboratory’s experience, microorganisms survive longer in/on textiles than on hard surfaces. For example, a study from 2009 showed 24% of doctors’ white lab coats to be contaminated with S. aureus (a close cousin of MRSA). That study did not use a sensitive sampling technique, so the incidence of contamination is probably even greater. Other textiles such as privacy curtains are also frequently contaminated. One study showed that within one week of laundering, 92% of privacy curtains showed MRSA or VRE.
Question: How does this importance weigh against the importance of sanitizing or disinfecting hard surfaces?
Dr. Benjamin Tanner: Sanitization of soft surfaces such as privacy curtains and lab coats should be done in at least the same frequency as surface disinfection, since patient and doctor contact with soft surfaces is reasonably common. Unfortunately, the optimal frequency of sanitization of soft surfaces is not known. Some studies indicate that surfaces become re-contaminated within just a few hours after sanitization, so sanitization multiple times per day would likely give the maximum benefit.
According to Dr. Charles P. Gerba:
â€œThis is an area we have been looking at recently. There is not much new literature, but the following abstract based on older research shows that the dose from blankets contaminated with influenza could infect mice. It is possible that dust containing organisms is generated when people move cloth materials around or sit on cloth cover furniture generating infectious aerosols. This does not happen with hard surfaces. Combine this with how seldom – if at all – cloth surfaces are sanitized and they could potentially be more of a risk even if transfer of organisms to the skin is less than hard surfaces. â€œ
Abstract of Older Research
FF Edward, MD
National Institute for Medical Research, United Kingdom
Recently attention has been directed to the part played by dust in the spread of disease, particularly infection due to Streptococcus pyogenes and Corynebacterium diphtheriae. Both these organisms are known to survive drying and can be recovered from the dust of rooms inhabited by infected patients (Thomas 1941, Crosbie and Wright 1941). Under experimental conditions it has been shown that by shaking and beating blankets on which streptococci have been dried the organisms can be distributed in the air on dust particles in a virulent form (Van den Ende, Lush and Edward 1940). In other infections the possibility of spread by dust obviously depends on the ability of the causal organisms to withstand drying. Although influenza is regarded as an airborne infection, little attention has been paid to transmission by dust and it has not been determined whether influenza virus can resist drying under natural atmospheric conditions, the only data collected having been in regard to its resistance to drying in vacuo in the cold. It was therefore decided to investigate the possibility that dust might be a factor in the spread of influenza and to determine the resistance of the virus to drying.