Health care workers often wash their scrubs at home, but doing so may be contributing to the spread of antibiotic-resistant infections in hospitals, new research suggests.
Home washing machines generally are insufficient for decontaminating health care worker uniforms, a study published Wednesday in PLOS One found. Researchers recommended hospitals launder scrubs on-site and update at-home washing guidelines for health care workers.
"Our research shows that domestic washing machines often fail to disinfect textiles, allowing antibiotic-resistant bacteria to survive," the researchers wrote. "If we're serious about transmission of infectious disease via textiles and tackling antimicrobial resistance, we must rethink how we launder what our healthcare workers wear."
Antibiotic resistance is a global health concern that led to more than 1 million deaths each year between 1990 and 2021, according a study published last year. It occurs when bacteria change in ways that evade current antimicrobial medications, limiting treatment for certain infections. More than 39 million people worldwide could die by 2050 from antibiotic resistance, the study found.
Though a majority of health care workers in the United States and England wash their scrubs and lab coats at home, previous research has found they are not educated on how to wash them. Researchers have raised concerns about the spread of infection.
A 2018 study found 30% of scrubs are contaminated with disease-causing bacteria. A literature review cited in 2020 by the Hastings Center for Bioethics found scrubs transmitted bacteria that was resistant to multiple antibiotics.
Additionally, a 2015 survey found a majority of health care providers required employees to wash their uniforms at home but offered no guidance on how to do so. A 2022 study conducted in England found nearly 20% of nurses and other medical providers who laundered their own uniforms failed to do so at the recommended temperature setting of 140 degrees.
For the new study, researchers tested the effectiveness of various machines at washing scrubs in hot water – on rapid and normal cycles. Rapid cycles did not disinfect the clothing swatches on half of the machines. One-third of the machines did not sufficiently clean the fabric on regular cycles.
Swabs from inside the machines also found bacteria that potentially could cause diseases, as well as antibiotic-resistance genes. Bacteria also can develop resistance to some detergents, potentially increasing antibiotic resistance, according to the study.