The high rates of the microbial contamination in the dresses and stethoscope of health care workers may be related to the fact that patients may continuously shed the infectious microbial organisms into the hospital environment, and the health care workers are in constant contact with these patients. It has also been established that, the microbial organisms can survive for 10 to 98 days on fabrics such as polyesters and cotton which are used to make white coats.⁵

Since the dresses and stethoscopes of health care workers can transmit the infections from one to another, we have designed this present study in around 100 different health care workers from various specialities or cadres in the hospital. From each individuals, one swab from the stethoscope (n=100) and four swabs from different parts of their dresses such as collar, pocket, sleeves and sides (n=400) were taken for bacteriological analysis.

Among the 100 health care workers, most of them were doctors (47) followed by nurses (31) and paramedical staffs (22). Though females (41%) were less in number compared to males (59%), they had higher rate of bacterial contamination (73%). [Table 1] This finding was similar to the study findings by Muhadi et al⁶ and contrary to the study findings of Banu et al⁷ who found out that male worker dresses are more contaminated than females.

Our study result showed, out of 400 samples, 285 samples (71%) were found to be contaminated with micro-organisms which is much lower compared to the study done by Moravvej et al⁸ (94%) and Uneke & Ijeoma⁹ (91.3%).

Collar and pocket of the dresses of health care workers were equally contaminated (26%) and was slightly more than the contamination on the sides and sleeves of the dresses (24%). This observation was similar to the study findings of Muhadi et al⁶ and Banu et al⁷ who showed that the collar and pockets are the most contaminated areas. [Table 2]

All the health care workers wash their coats on their own and more than 50% of the hospital workers wash their coats twice a week. The data from washing practices of dresses of health care workers revealed that the microbial organism contamination varied with the duration of the coats in use. This was contrary to the findings of Wong et al¹⁰ who showed that the level of bacterial contamination did not vary with the length of time a dress had been in use.

Among the participants 28% of them used their white coats only in the wards, while 63% used it both in wards and as well as within campus including canteen/mess and 9% used both inside and outside the hospital premises. Similar reports were observed in the study done by Muhadi et al⁶.

76% of the health care workers claimed to use hand sanitizer before and after attending patients and the microbial contamination were found to be much less when compared with the non-users (24%). [Table 5]

In this present study, the most common organism isolated from the dresses of the health care workers was found to be Staphylococcus aureus. This was similar to the study findings of Muhadi et al⁶, Wong et al¹⁰ and Treakle et al¹¹ and different from the study findings by Uneke and ijeoma⁹ in which diphtheroids was found to be the most commonly isolated organism.[Table 4]

Among the samples taken from the stethoscope of 100 different health care workers, as many as 84% of the stethoscope [Table 3] were contaminated with microorganisms which was comparable to the observations from the previous studies done by Youngster et al¹², Zuliani et al¹³ and Wood et al¹⁴ which showed that 71-100% of stethoscopes were contaminated by different microorganisms. Among them, Staphylococcus aureus was found to be the most common isolate followed by the Coagulase negative Staphylococcus (CONS).

The antimicrobial susceptibility pattern of the Gram-positive cocci such as Staphylococcus aureus and Coagulase negative Staphylococci (CONS) showed that most of the organisms were resistant to the drug Co-trimoxazole and Penicillin. Whereas, Ciprofloxacin was found to have maximum resistance for the Gram-negative bacilli such as Pseudomonas aeruginosa and Klebsiella sp. These findings are consistent with the study results shown by Uneke and Ijeoma⁹.

Even though most of the organisms isolated in this present study were considered to be non-pathogenic, a considerable fraction of the isolates were pathogenic. Some of the pathogenic organisms like Methicillin Resistant Staphylococcus Aureus (MRSA), Klebsiella sp and Pseudomonas aeruginosa are infectious to the patients who are admitted in the hospital and play a very important role in transmitting the infections from one patient to another. In this study, the percentage of MRSA isolated was 3% which was significantly lower than the study findings done by Treakle et al¹¹ where it was reported that 18% of MRSA are found in the dresses of health care workers.