1351. The Antiseptic Scrub Contamination and Transmission (ASCOT) Trial: a 3-Arm Cluster-Randomized Controlled Crossover Trial to Determine the Impact of Antiseptic-Impregnated Scrubs on Healthcare Worker Contamination
Session: Poster Abstract Session: Clinical Trials
Friday, October 28, 2016
Room: Poster Hall
Background: HCP clothing becomes contaminated during patient care and can serve as a vector for subsequent transmission. Antimicrobial-impregnated clothing may reduce contamination, but clinical data are lacking.

Methods: We performed a blinded cluster-RCT with crossover to compare acquired contamination of two types of antiseptic-impregnated scrubs (S1= complex element compound with a silver-alloy; S2=organosilane-based quaternary ammonium and a hydrophobic fluoroacrylate copolymer emulsion) to standard cotton-poly scrubs during clinical care. 40 nurse subjects were randomized to wear each of the 3 scrub types during 3 consecutive 12-hour ICU shifts (during which each nurse cared for patients in 2 rooms). Microbiological cultures were obtained from the HCP clothing (sleeve, abdomen, and chest pocket) and the 2 hospital rooms (bed, bedrail, and supply cart) using RODAC plates at the beginning and end of each shift. The primary outcome, total bacterial CFU on clothing at the end of shift, was assessed using a GEE linear regression model while adjusting for crossover, contamination before the shift, and the amount of environmental contamination observed during the shift.

Results: 167 unique patients received care from 40 nurse subjects over 120 individual shifts (Table); 2,185 cultures were obtained from HCP clothing, 455 from patients, and 2,919 from patientsÕ environments. The median unadjusted increases in contamination were similar among scrub types (median (IQR) CFU Æ: C 61.5 (-3, 191), S1 73 (-107, 194), S2 67 (-59, 222), Figure). Scrub type was not associated with a decrease in HCP clothing contamination in our adjusted multivariable analysis (overall p=0.94; S1 p=0.72; S2 p=0.85).

Conclusion: Antimicrobial-impregnated scrubs did not lead to decreased contamination of nursesÕ clothing.

Table. Characteristics of patients who received care from nurse subjects

Control

N=57

n (%)

Scrub 1_

N=57

n (%)

Scrub 2

n=53

n (%)

Median length of ICU stay (IQR)

4 (2-12)

4 (1-13)

3 (1-7)

Contact Precautions

15 (26)

12 (21)

12 (23)

Diarrhea

19 (34)

24 (42)

15 (28)

Mechanical ventilation

24 (42)

29 (51)

29 (56)

Wound present

31 (54)

36 (63)

27 (51)

Known history of or infection with any MDRO

16 (29)

15 (29)

15 (29)

Figure. Contamination of HCP clothing and average environmental contamination in patient rooms.

U:\Studies\Scientific Meetings\ID Week 16\ASCOT primary\Figure - median cfu.tif

Deverick Anderson, MD, MPH, FIDSA, FSHEA1, Rachel Addison, MT (ASCP), MPH2, Yuliya Lokhnygina, MS, PhD3, Sarah S. Lewis, MD MPH1, Rebekah W. Moehring, MD, MPH1,4, David J. Weber, MD, MPH, FIDSA, FSHEA5, William a. Rutala, PhD, MPH5, Daniel J. Sexton, MD, FIDSA, FSHEA1 and the CDC Prevention Epicenters Program, (1)Duke Infection Control Outreach Network, Duke University Medical Center, Durham, NC, (2)Duke Infection Control Outreach Network, Durham, NC, (3)Biostatistics and Bioinformatics, Duke University, Durham, NC, (4)Durham VA Medical Center, Durham, NC, (5)Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, NC

Disclosures:

D. Anderson, None

R. Addison, None

Y. Lokhnygina, None

S. S. Lewis, None

R. W. Moehring, None

D. J. Weber, None

W. A. Rutala, None

D. J. Sexton, None

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