From hospital to home: How scrubs could be spreading drug-resistant germs
A medical doctor makes size appropriate anti-microbial medical scrubs for female and male doctors in Kenya.
What you need to know:
- Researchers warn everyday exposure to contaminated medical attire could silently spread drug-resistant infections across communities.
- Health experts link improper handling of scrubs to rising antimicrobial resistance and increased public health risks.
Picture this, you are seated in a public transport next to a health practitioner wearing a colourful blue medical scrub. The look in your eyes towards the health worker are those of admiration, to you, he or she is from saving a life or lives and automatically qualifies to be a hero.
Unknown to you, however, he or she is now putting your life at risk. Dr Silas Owuor, a leading researcher at the Jaramogi Oginga Odinga Teaching and Referral Hospital, says misuse of scrubs remains a major threat to the management of antimicrobial resistance (AMR). The World Health Organization (WHO) says AMR occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines.
As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become difficult or impossible to treat, increasing the risk of disease spread, severe illness, disability and death. The WHO estimates that in 2019 alone, almost 1.27 million deaths were recorded as a result of AMR.
Dr Owuor explains that contact with the medical attire in public places or hospitals is likely to result in transmission of infections. According to the expert, while healthcare providers are fully aware of the existing risk, a larger number has continued to dress in scrubs in public places, endangering lives of those around them. The practice, he says, remains common in public vehicles, supermarkets, shopping centres and even homes.
“We are in an era of AMR and one major concern is cross-contamination of pathogens from one point to another. Since medics use scrubs to care for patients, the attire remains a major carrier of multidrug resistant pathogens from the healthcare set up to the environment,” says Dr Owuor.
According to the AMR expert, a scrub is an attire used by a health provider to protect those around them from cross-contamination. This he says includes facemasks, gloves, shoes, headgear, and any other attire won by healthcare providers at their workplace. In his latest research, Antimicrobial Resistance across one Health Framework, the medical officer explores the environmental contamination through wearing scrubs in public by health workers.
The results of AMR, he says, include poor health outcomes, increased healthcare expenditure and reduced food production. He argues that when patients visit health facilities in the hope of getting treatment, health workers always wear protective gear to protect their patients from nosocomial infections.
“Most of the health workers are often seen in the attires in grocery shops, hotels and non-clinical areas within hospitals. Some wear the same scrubs while carrying their children to school, exposing community members and patients to their contaminated clothing,” argues Dr Owuor in the study. “While health facilities have been promoting hygiene by providing handwashing stations, re-contamination from the microbial contaminated uniform remains common as they wipe their hands on the scrubs or keep pocketing.”
The spread of infections, he says, does not end in public places. Back at home, the disinfected attires are always washed with normal soap alongside other clothing, leaving the entire load of clothes contaminated. “Immediately after washing, the water is poured out to the environment. A cow around the home will feed on the contaminated grass and the infection cycle continues,” he says.
The study is further backed by a previous report by Occupational Safety and Health Administration that the medical scrubs are always contaminated through perspirations, human secretions of oil or items handled while on duty. The report argues that contamination is increased by continued wearing of the scrub without washing. “According to the organisation, contaminated scrub attire should not be taken out of a hospital environment,” Dr Owuor says.
In his study, a health worker picked a handful of swabs from the scrubs where he found a mixed growth of hospital and environmental acquired infections. He had later proceeded to test the resistance and a majority turned out to be multidrug resistant. The health worker says that in 2024, the Kisumu government wrote a memo warning health workers against wearing scrubs outside health facilities.
Practice now widespread
Kisii County followed suit, but to date, the practice remains common across the country, putting the lives of unsuspecting citizens at risk. The expert now argues that it is time health facilities were well-equipped with laundry stations to handle health staff. The facilities, he says, should also devise a method of inspecting health workers to ensure they do not leave with contaminated scrubs.
“We should have a change room in facilities where the medics can change their dressing before or after seeing patients,” he says. “Let us just bring back the old days where we had government-donated green scrubs, which would be left by the medics at the facility at the end of the day for cleaning.”
He further explains that it is the role of every citizen to remind a healthcare worker that wearing scrubs in public endangers both humans and the environment. “If none of this is done, we are looking at an increased AMR infections and deaths in the near future,” he says.
