LAUSR

Dear Editor, Physicians have traditionally worn scrubs or white coats to easily identify themselves to patients. Patients report increased confidence and willingness to share sensitive information with physicians wearing white coats compared to those casually dressed. In this letter, we describe current data on physician clothing as a source of microbial transmission and make evidence-based recommendations regarding clothing practices during the coronavirus disease 2019 (COVID-19) pandemic. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is viable on stainless steel, plastic, and cardboard for up to 72 hours. SARS-CoV-2 viability on fabric has not been tested; however, nosocomial bacteria survive between 10 and 98 days on cotton or polyester. Therefore, physician clothing may act as vehicles for disease transmission as a result of contamination (Table 1). In a study examining 238 cultures from the sleeves, waists, and pockets of 135 physicians and nurses, 63% of physicians were positive for multidrug-resistant organisms in at least one site. In an observational study, 120 of 585 (21%) physician-patient interactions in intensive care units (ICU) resulted in bacterial contamination of physician gowns or gloves. In a prospective randomized crossover trial of 31 ICU physicians, a 4 to 7 mean log reduction in surface methicillin-resistant Staphylococcus aureus (MRSA)