Kırıkkale Üniversitesi Tıp Fakültesi'nde sağlık çalışanlarının önlüklerindeki bakteriyolojik kontaminasyonların incelenmesi

Amaç: Hastane ortamında beyaz önlükler patojenik bakterilerin yayılmasında rol oynayabilirler. Bu çalışmada sağlık personelinin kullandığı beyaz önlüklerin bakteriyel kontaminasyonu araştırılmıştır. Aynı zamanda sağlık personeline önlüklerinin kullanımı hakkında anket uygulanmıştır. Gereç ve Yöntem: Beyaz önlüklerden steril salin ile nemlendirilmiş eküvyonlar kullanılarak kültür alınmıştır. Alınan örnekler kanlı ve endo metilen blue agara ekilmiş, 37°C’de 48 saat inkube edilmiştir. Standart mikrobiyolojik metodlar kullanılarak bakteriler tanımlanmıştır. Beş sorudan oluşan anket formu uygulanmıştır.   Bulgular: Doksan altı sağlık sağlık çalışanı çalışmaya alınmıştır. Önlüklerin %25’inde (24/96) bakteriyel kontaminasyon saptanmıştır. Bakterilerin çoğu %62.5 (15/24) koagulaz negatif stafilokoklardır. En yüksek bakteriyel kontaminasyon oranı (%44) yoğun bakım ünitesinde çalışan sağlık personelinin önlüklerinde saptanmıştır. Anket sonuçlarına göre personelin genellikle önlüklerini kendileri yıkadıkları, dahili ve cerrahi birimlerdeki personelin yemek yerken genellikle önlüklerini çıkarmadıkları saptanmıştır.     Sonuç: Sonuç olarak beyaz önlüklerin bakterilerle kontamine olabileceğinin bilinmesi, el hijyenine/yıkamasına önem verilmesi ve mümkünse klinik dışı ortamlarda (yemekhane, kantin gibi) önlüklerin giyilmemesi konularında sağlık personelinin bilgilendirilmesi uygun olacaktır.   

Investigation of bacteriological contamination in white coats of health care workers in Kırıkkale University, Faculty of Medicine

Objective: White coats may play a role in transmitting pathogenic bacteria in a hospital environment. This study was investigated bacterial contamination of the white coats used by healthcare workers (HCW). At the same time, health care workers were questioned about the use of their white coat.Material and Method: Samples for culture were collected from white coats using the sterile swabs moistened with sterile normal saline. Collected samples were cultured on blood agar and Endo metilen blue agar plates, which were incubated at 37°C for 48 hours. Bacteria were identified using standard microbiological methods. A questionnaire consisting of five questions was applied.Results:  A total of 96 HCW participated in this study. %25 (24/96) of the white coats had bacterial contamination. Most % 62.5 (15/24) were coagulase negative Staphylococci. The highest bacterial contamination rate (%44) was found in the white coats of the health personnel working in the adult intensive care unit. According to the results of the questionnaire, it was found that the HCW’s generally wash their own white coats themselves and the personel working for the units internal and surgical do not take their coats off when they eat. Conclusion: As a result, it would be appropriate to inform the health personnel about white coats may be contaminated with bacteria, to give importance to hand hygiene / washing and, if possible, to not wear gowns in non-clinical settings (such as cafeteria, canteen).

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  • 1. Yallew WW, Kumie A, Yehuala FM. Risk factors for hospital-acquired infections in teaching hospitals of Amhara regional state, Ethiopia: A matched-case control study. PLoS One 2017; 12(7): e0181145.
  • 2. Karahocagil MK, Yaman G, Göktaş U, Sünnetçioğlu M, Çıkman A, Bilici A, Yapıcı K, Baran Aİ, Binici İ, Akdeniz H. Hastane Enfeksiyon Etkenlerinin ve Direnç Profillerinin Belirlenmesi. Van Tıp Dergisi 2011; 18 (1): 27-32.
  • 3. Sheng WH, Chie WC, Chen YC, Hung CC, Wang JT, Chang SC. Impact of nosocomial infections on medical costs, hospital stay, and outcome in hospitalized patients. J Formos Med Assoc Taiwan Yi Zhi 2005; 104: 318–26.
  • 4. Banu A, Anand M, Nagi N. White coats as a vehicle for bacterial dissemination. J Clin Diagn Res. 2012 Oct;6(8):1381-4.
  • 5. Muhadi SA, Aznamshah NA, Jahanfar S. A cross sectional study on the microbial contamination of the medical student’s white coats. Malayasian Journal of Microbiology. 2007;3(1):35-8.
  • 6. Mackie, Mc Cartney . In: Practical Medical Microbiology. 14th. Collee JG, Fraser AG, Marmion BP, Siminons A, editors. New York: Churchill Livingston; 1996.
  • 7. Clinical and Laboratory Standards Institute. Performance standards for Antimicrobial Susceptibility testing; Twenty First Informational Supplement. CLSI document M100-S21. Wayne, PA: Clinical and Laboratory Standards Institute; 2011. 8. Srinivasan M, Uma A, Vinodhkumaradithyaa A, Gomathi S, Thirumalaikolundusubramanian P. “The Medical Overcoat – Is It a Transmitting Agent for Bacterial Pathogen?” Japanese Journal of Infectious Diseases 2007; 60: 121–2.
  • 9. Treakle AM, Thom KA, Furuno JP, Strauss SM, Harris AD, Perencevich EN. “Bacterial Contamination of Health Care Workers’ White Coats.” American Journal of Infection Control 2009;37(2): 101–5.
  • 10. Chacko L, Jose S, Isac A, Bhat KG. “Survival of Nosocomial Bacteria on Hospital Fabrics.” Indian Journal of Medical Microbiology 2003; 21(4): 291.
  • 11. Uneke CJ, Ijeoma PA. The Potential for Nosocomial Infection Transmission by White Coats Used by Physicians in Nigeria: Implications for Improved Patient-Safety Initiatives. World Health & Population 2010; 11(3): 44-54.
  • 12. Qaday J, Sariko M, Mwakyoma A, Kifaro E, Mosha D, Tarimo R, Nyombi B,Shao E. Bacterial Contamination of Medical Doctors and Students White Coats at Kilimanjaro Christian Medical Centre, Moshi, Tanzania. Int J Bacteriol. 2015;2015:507890.
  • 13. Martins A, Cunha MLRS. Methicillin resistanece in Staphylococcus aureus and coagulase negative staphylococci: Epidemiological and molecular aspects. Microbiol Immunol Rev, 2007; 51: 787-95.
  • 14. Priya H, Acharya S, Bhat M, Ballal B. Microbial Contamination of the White Coats of Dental Staff in the Clinical Setting. J Dent Res Dent Clin Dent Pros 2009; 3(4): 136-40.
  • 15. World Health Organization, Prevention and Control of Hospital-Acquired Infections, A Practical Guide,World Health Organization, Geneva, Switzerland, 2nd edition, 2002, http://www.who.int/emc.