Bacterial contamination of surgical scrubs in the operating theater.

BACKGROUND: Measures for the prevention of postsurgical infections include issuing special scrubs for the operating room (OR) and prohibiting walking out of the OR complex wearing these scrubs. The aim of this study was to provide further data on bacterial contamination of surgical scrubs. METHODS: Specimens were collected at the entrance to the OR from surgical scrubs worn by surgeons. Participants completed a questionnaire regarding the times, places, and activities in which they were involved during the time interval they were wearing the scrubs. RESULTS: Among the 133 surgeons who participated, the median colony-forming unit (CFU) count was higher (39 CFU/plate) for their scrubs than for clean scrubs worn by the control group (3 CFU/plate; n = 11; P < .001), but there was no significant difference between the study and control groups in the rate of carriage of pathogenic bacteria (13% and 9%, respectively). The majority of the bacteria isolated were considered commensals. Fifty-five (41%) of the surgeons stated that before sampling they took part in medical activities, and 45 (34%) participated in non-medical activities. Practicing these activities was associated with a higher number of CFUs compared to not being involved in such activities (P < .05). CONCLUSIONS: Our data show that, even in less than optimal situations when scrubs are worn outside the OR, surgical scrubs are contaminated with a low bacterial load and only a small number of pathogenic bacteria.

Spread of Carbapenem and Colistin-Resistant Klebsiella pneumoniae ST512 Clinical Isolates in Israel: A Cause for Vigilance.

OBJECTIVES: Genomic and phenotypic characterization of resistance mechanisms to carbapenems and colistin in Klebsiella pneumoniae strains isolated from the Shaare Zedek Medical Center (Jerusalem, Israel). RESULTS: The 15 K. pneumoniae isolates studied present a high level of resistance to the antibiotics tested. Microbiological tests revealed production of carbapenemase enzymes by all isolates. ABI SOLiD sequencing of K. pneumoniae genomes generated between 5,033,665 and 8,876,861 million reads per genome. The genomic study revealed that carbapenem resistance was mediated by production of the KPC-3 enzyme in 13 isolates and NDM-1 enzyme in the remaining 2 isolates. In addition, colistin resistance was induced either by a missense mutation in the mgrB gene or inactivation of mgrB by an IS5-like insertion sequence. The mobile genetic element, transposon Tn4401, was identified in all genomes harboring the blaKPC gene. The 15 K. pneumoniae strains were assigned to 4 different sequence types, including ST16, ST76, ST258, and ST512. CONCLUSION: In this study, we report the usefulness of whole-genome sequencing in detection of antibiotic resistance mechanisms and in highlighting the emergence of the carbapenem and colistin-resistant K. pneumoniae clone ST512 in Israeli hospitals.