Research Article

iMedPub Journals Journal of Pathogen Research 2018

www.imedpub.com Vol.1 No.1:2

White Coat as a Contamination Agent

Lohaynne Zambon Dir, Walter Bissa Paulino, Luciano Simões Trarbach, João Damasceno
Lopes Martins and Clarisse Maximo Arpini*
Department of Microbioloy, University of Vila Velha – UVV, Espirito Santo, Brazil
*Corresponding author: Clarisse Maximo Arpini, Department of Microbiology, University of Vila Velha - UVV, Espirito Santo, Brazil, Tel:
+55-27-34212168; E-mail: [email protected]
Received date: January 10, 2018; Accepted date: January 29, 2018; Published date: February 01, 2018
Copyright: © 2018 Dir LZ, et al. This is an open-access article distributed under the terms of the creative Commons Attribution License, which
permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Citation: Dir LZ, Paulino WB, Trarbach LS, Martins JDL, Arpini CM (2018) White Coat as a Contamination Agent. J Pathogen Res Vol.1 No.1:2.
educational and research institutions, companies and health
facilities require its use.
Abstract
Concomitant with this awareness of individual protection,
Background: The study was delineated from the
we frequently see the use of the white coat in improper
hypothesis of the irrational use of the white coats outside environments, such as dining rooms, coffee shop and even
the place destined to its use, in that way transforming it shopping malls, generating the risk of cross contamination
into agent of contamination. between environments. Between health professionals,
frequently, the seriousness of the issue is neglected by
Methods and findings: We developed a questionnaire to arrogance or ignorance of some basic concepts of
be answered by volunteers approached on the campus of microbiology [2,3].
a private university, aiming at a social study of the reasons
Studies have shown that uniforms and white coats have
for the use of the white coat and awareness about its
become progressively contaminated during their use and that
function. Our main limitation was in relation to medical
the contamination reaches a saturation level until stabilizing in
students who only perform ambulatory care in associated
clinics, but off campus.
a plateau [2]. So, the objectives of this study were to evaluate
the level of contamination of white coats of students,
Results: The antibiogram didn't show no one significant professors and employees of a private university, with
resistance profile, instead of other studies that reporting identification of microorganisms, verification of potential
even Staphylococcus aureus MRSA, but some Gram- virulence and resistance to antibiotics. In parallel, we try to
positive isolates showed resistance for Penicillin, relate the level of contamination with the frequency of
Ampicillin and Gentamicin and all Gram-negative isolates exchanges per week and conduct a social study on the habits
showed resistance for Amoxicillin. of use of the white coat.

Conclusions: We can conclude that, mainly among

students in the area of human health, there is a
Materials and Methods
disinformation or disregard for the risk of transmission of For the accomplishment of the study, collections were made
pathogens by the lab coats. We found microorganisms of with interviews at the Campus of biologic and health activities.
various types, mainly yeasts; however, among the isolated
Gram-positive cocci, Staphylococcus aureus and The voluntary was approached and invited to participate in
coagulase-negative Staphylococcus sp. were the ones that the study anonymously. A questionnaire was answered (Figure
corresponded to the largest number. 1) while one of the research components carried out the
material collection.
Keywords: White-coat; Lab-coat; Contamination;
The collections were performed in the region of the collar,
Staphylococcus; E. coli
pocket and wrist of the user's dominant hand (right-handed or
left-handed). Sterile swabs and a template, used to delineate
the collection area, were used to collect the samples and thus
Introdution calculate the number of contaminants per area. The collected
samples were identified by code.
The white coat, in Brazil, is still no legislation that
standardize white coat with according to the function The volunteers received a code corresponding to their
performed of its users [1]. Nevertheless, it is recognized that it analysis, if there was interest in the results.
is necessary to use it for personal protection and, therefore,

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In the Microbiology laboratory the samples were inoculated After growth, counting and identification were performed.
in Plate Count Agar (PCA), BHI broth (Brain Heart Infusion Some isolated microorganisms were selected for antibiotic
Broth) and Blood Agar, in order to perform the counting of the resistance testing.
microorganism and identification of these. They were then
incubated under 36°C for 48 hours, for the growth of bacterias,
and under 25°C for until 7 days, for the growth of fungus.

Figure 1 Questionnaire conducted with the volunteers.

Results laboratory employees. In an overall assessment, when asked

about the reasons for the use of the white coat, most
interviewees responded that they used it for safety (Table 1).
Results of the questionnaire (Social study)
Of the total number of volunteers, 58% were female and, of
the total, 72% were students and, the other, professor or

Table 1 Results of social study according the questionnaire.

Reasons for Use of White X Coat

Safety Obligation Work uniform Protection of TOTAL

sample

Women (total of volunteers) 81% 14% 0% 5% 100%

Men (total of volunteers) 53% 33% 13% 0% 100%

Students 30% 62% 4% 4% 100%

Reasons for Use of White Oat According to Professional Group

Safety Obligation Work uniform Protection of TOTAL

sample

Laboratory employees / Professor 90% 0% 10% 0% 100%

Medicine students 0% 100% 0% 0% 100%

Veterinary Medicine students 100% 0% 0% 0% 100%

Pharmacy students 50% 0% 0% 50% 100%

Chemistry Engineer students 100% 0% 0% 0% 100%

Dentistry students 0% 100% 0% 0% 100%

Biology students 50% 25% 25% 0% 100%

Other Engineers students 75% 25% 0% 0% 100%

Place of Use of the White Coat According to Professional Group

Outside Workplace At Workplace TOTAL

Laboratory employees / Professor 40% 60% 100%

Medicine students 33% 67% 100%

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Veterinary Medicine students 0% 100% 100%

Pharmacy students 0% 100% 100%

Chemistry Engineer students 0% 100% 100%

Dentistry students 0% 100% 100%

Biology students 0% 100% 100%

Other Engineers students 33% 77% 100%

However, when we analyzed exclusively the student’s Microorganisms of various species was identified, such as
responses, most of them (35%) had responded that they were Staphylococcus aureus, coagulase-negative Staphylococcus,
using for obligation (Table 1). Our results correspond to the Streptococcus viridans group, Enterococcus sp., Escherichia
results of Banu et al. who report several reasons for the use of coli, and Pseudomonas sp. among other bacteria, besides yeast
white coat beyond for safety [4]. (that corresponded to 50% of the isolates) and filamentous
fungi like Aspergillus sp. and Penicillium sp. In contraste,
Analyzing the students' responses per course, most of them
Margarido et al. report in their research the frequency of 50%
do not admit to wearing their white coat outside the study
of Staphylococcus sp. in their research about the white coat of
work place (Table 1), however this does not correspond to
health academics. In other researchers, was found just
what is observed within the Campus. The fact that drew our
Staphylococcus aureus, Pseudomonas aeruginosa and E. coli
attention was that the groups that most answered about the
[3,7].
use of obligation of white coats were medical students and
students of dentistry. This fact shows us the lack of The antibiogram didn't show no one significant resistance
preoccupation or few information about the possibility of the profile, instead of other studies that reporting even
white coats is an important pathogens vehicle. Staphylococcus aureus MRSA, but some Gram-positive isolates
showed resistance for Penicillin, Ampicillin and Gentamicin
Results of microbiologoical analyzes and all Gram-negative isolates showed resistance for
Amoxicillin, even as reported Robati et al. [4,6,8].
Microbiological analyzes of the level of contamination show
that there is no significant difference between the analyzed
sites (collar, pocket and sleeve), but confirm the idea that, the Discussion
higher the frequency of exchanges (washes), the lower the According to other researchs, the possible justifications for
level of contamination, as shown, for example, in pockets the indiscriminate use of lab coats outside the work
analyzes (Figure 2). environment can be mentioned: the short time available for
Priya et al. as well as Treakle et al. showed the same profile the exchange of clothing, the fact that the professionals do not
of cleaning habits and exchange of white coat that our study, give due importance to the risk of contamination, or because
where and students generally do not show concern about the their use in public places would be related to status [9]. This
possibility of transmission of pathogens to other people or to was also shown in our study, mainly by students of medicine
themselves [5,6]. and dentistry, that’s which leads us to concern with the type of
professional we are training. The irresponsible use of white
coats outside the appropriate place is reported by Robati et al.
showing that this problem is frequent, mainly between human
health students
Although several studies have shown that even with
progressive contamination of the lab coat, associated with
poorly performed changes or washes, there is a growth
plateau, however other studies have shown that the survival of
microorganisms in tissues, such as cotton and polyester, can
last 10 to almost 100 days [2,8].
The contrast of other researchers with our isolates can be
Figure 2 Pockets contamination level according to number explained to the focus of the volunteers. In most studies,
of weekly washes / exchanges. volunteers are from the health area. In our work, we do not
limit the area where the volunteer works or studies. Anyway,
among the Gram-positive cocci we isolated, Staphylococcus
We did not find a high microbial count in most of the aureus and Staphylococcus sp. corresponded to the majority of
analyzed white coats, but when analyzing the types of isolates the isolates.
besides the high presence of fungi and yeasts, we found
several groups of bacteria.
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Vol.1 No.1:2

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