Tag Archives: Journal of Hospital Infection

Neckties: A Magic Carpet Ride for Bacteria?

My necktie collection needs a makeover, at least some vim and a spray-down with Febreze to mask their musty smell.

Three of my favorite ties, which could be harboring transmittable bacteria. Nice. Photo by Doug Brunk/Elsevier Global Medical News

I keep my collection hanging on a tie rack shoved in the far corner of my closet, barely within reach and safe from potentially damaging ultraviolet rays. Wearing ties underwhelms me, though I consider three as prized possessions. These include a tie that celebrates horseracing at the Del Mar Thoroughbred Club, another tastefully decorated with the Great Seal of the State of New York (my home state), and one littered with different Donald Duck facial expressions, a gift from a former boss who had a tendency to call me “Duck” instead of Doug.

Results from a small controlled experiment published online Feb. 3, 2012, in the Journal of Hospital Infection have me worrying about my tie collection now, though. If its results are correct, these ties collectively might contain enough bacteria to grow mushrooms that I could add to a homemade marinara sauce, perhaps even enough to help spawn life on some planet in a faraway galaxy.

For the experiment, a team of researchers from Scott and White Healthcare, a general medical and surgical hospital based in Temple, Tex., set out to investigate the extent to which shirt sleeve length and/or the wearing of a tie affects the rate of transmission of bacteria from an examiner to a patient. One physician wore four clothing combinations: long sleeve shirt with unsecured tie, long sleeve without tie, short sleeve with tie, and short sleeve without tie. The physician performed mock history and physical examinations on five clothed mannequins dressed in hospital gowns in a simulation center while the researchers obtained cultures from the physician’s tie, shirt sleeves, and from each mannequin’s cheek, right hand, and abdomen before and after the mock examinations.

“The control cultures of the physician’s clothing inoculation sites in each combination group both before the first simulated patient interaction and after the last one demonstrated greater than 300 colony-forming units of micrococcus on each,” the researchers reported. “This confirmed the assumption that the bacteria were alive prior to and at the end of the encounters. The culture of the deliberate contamination site grew 44 colonies, demonstrating the ability of the mannequin to be inoculated by an article of clothing.”

They went on to discover that cultures taken from the abdomen, cheek, and hand sites of the mannequin prior to encounter “grew a total of five colonies of contaminant bacteria. There was no growth of micrococcus on any simulated patient prior to the history and physical examination.”

Simulated patient encounters in which an unsecured tie was worn had significantly more mannequins contaminated with micrococcus compared with those encounters in which an unsecured tie was not worn. However, sleeve length had no significant impact on the colonization rates.

“Neckties most often end at the waist, swing, and are not readily machine washable,” the researchers observed. “In patient interactions, unsecured ties may swing across an infected field either to transmit bacteria to the patient, or to the cleansed hands of the provider which are then transferred to the patient. Our report provides evidence for a policy suggesting that physicians should not wear unsecured ties when seeing patients.”

The experiment did not factor in the game-changing potential of wearing tie tacks to keep neckties from swinging like a pendulum.

I guess it was only a matter of time before neckties would become the subject of healthcare-associated infection risk, with previous studies having established clear bacterial transmission links through unwashed hands, hospital curtains, and white coat sleeves. It begs a sobering question, though: where is the next undiscovered bacterial carrier lurking? Let me mull that over, but I’d like to wash my hands first.

— Doug Brunk (on Twitter@dougbrunk)

Photo by Doug Brunk/Elsevier Global Medical News


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Filed under Allergy and Immunology, Family Medicine, Hospital and Critical Care Medicine, IMNG, Infectious Diseases, Internal Medicine, Uncategorized