{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:13:27Z","timestamp":1785392007405,"version":"3.55.0"},"reference-count":23,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T00:00:00Z","timestamp":1640908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Healthcare workers\u2019 (HCW) clothing has been shown to harbor multidrug-resistant bacteria (MDRB) and may contribute to transmission. The aim of this study was to evaluate presence of MDRB on HCW uniforms in Cyprus. A cross-sectional study was carried out in 9 hospital wards and 7 long-term care facilities (LTCFs) in Nicosia, Cyprus, from April\u2013August 2019. Sampling of HCW uniform pockets was conducted at the end of the first shift. Personal hygiene and other habits were recorded during personal interviews. Among 140 sampled HCW (69 from hospitals, 71 from LTCFs), 37 MDRB were identified, including 16 vancomycin-resistant enterococci (VRE), 15 methicillin-resistant Staphylococcus aureus (MRSA), 5 extended spectrum b-lactamase (ESBL)-producing bacteria, and 1 carbapenem-resistant Acinetobacter baumannii. Presence of MDRB was higher in LTCFs compared to hospitals (p = 0.03). Higher MDRB rates in uniforms were noted in HCWs that worked &lt;1 year (41.7% vs. 21.1%) and in HCWs that opted for home laundering (23.5% vs. 12.5%) or visited the toilet during shifts (38.1% vs. 20.2%). Our findings indicate that HCW uniforms harbor MDRB and relevant interventions may reduce transmission risk. We identified LTCFs as an important area for targeted measures. Additional factors associated with HCW practices, characteristics, and attire laundering practices represent areas for improvement, particularly in LTCFs.<\/jats:p>","DOI":"10.3390\/antibiotics11010049","type":"journal-article","created":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T20:49:38Z","timestamp":1641242978000},"page":"49","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Multidrug-Resistant Bacteria on Healthcare Workers\u2019 Uniforms in Hospitals and Long-Term Care Facilities in Cyprus"],"prefix":"10.3390","volume":"11","author":[{"given":"Pavlina","family":"Lena","sequence":"first","affiliation":[{"name":"Mpn Unilab Clinical Laboratory, Nicosia 1066, Cyprus"},{"name":"Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5476-6576","authenticated-orcid":false,"given":"Spyridon A.","family":"Karageorgos","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, Nicosia 2404, Cyprus"},{"name":"First Department of Pediatrics, \u201cAghia Sophia\u201d Children\u2019s Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panayiota","family":"Loutsiou","sequence":"additional","affiliation":[{"name":"Mpn Unilab Clinical Laboratory, Nicosia 1066, Cyprus"},{"name":"Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annita","family":"Poupazi","sequence":"additional","affiliation":[{"name":"Mpn Unilab Clinical Laboratory, Nicosia 1066, Cyprus"},{"name":"Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8535-6601","authenticated-orcid":false,"given":"Demetris","family":"Lamnisos","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7595-5616","authenticated-orcid":false,"given":"Panagiotis","family":"Papageorgis","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7865-8529","authenticated-orcid":false,"given":"Constantinos","family":"Tsioutis","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1056\/NEJMoa1914433","article-title":"Multidrug-Resistant Bacterial Infections in U.S. Hospitalized Patients, 2012\u20132017","volume":"382","author":"Jernigan","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1016\/j.ajic.2007.10.007","article-title":"2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings","volume":"35","author":"Siegel","year":"2007","journal-title":"Am. J. Infect. Control"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S165","DOI":"10.1016\/j.ajic.2007.10.006","article-title":"Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006","volume":"35","author":"Siegel","year":"2007","journal-title":"Am. J. Infect. Control"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1017\/ice.2016.192","article-title":"Healthcare Personnel Attire and Devices as Fomites: A Systematic Review","volume":"37","author":"Haun","year":"2016","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1071\/HI10036","article-title":"Nurses\u2019 Uniforms\u2014The Missing Link in Breaking the Chain of Hospital Acquired Infection?","volume":"16","author":"Halliwell","year":"2011","journal-title":"Healthc. Infect."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1128\/JCM.38.2.724-726.2000","article-title":"Survival of Enterococci and Staphylococci on Hospital Fabrics and Plastic","volume":"38","author":"Neely","year":"2000","journal-title":"J. Clin. Microbiol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Lena, P., Ishak, A., Karageorgos, S.A., and Tsioutis, C. (2021). Presence of Methicillin-Resistant Staphylococcus Aureus (Mrsa) on Healthcare Workers\u2019 Attire: A Systematic Review. Trop. Med. Infect. Dis., 6.","DOI":"10.3390\/tropicalmed6020042"},{"key":"ref_9","unstructured":"European Centre for Disease Prevention and Control (EU Body or Agency) (2018). Surveillance of Antimicrobial Resistance in Europe: Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS Net) 2017, Publications Office of the European Union."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1086\/338461","article-title":"Patients in Long-Term Care Facilities: A Reservoir for Vancomycin-Resistant Enterococci","volume":"34","author":"Elizaga","year":"2002","journal-title":"Clin. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1017\/ice.2018.160","article-title":"Patient Contact Is the Main Risk Factor for Vancomycin-Resistant Enterococcus Contamination of Healthcare Workers\u2019 Gloves and Gowns in the Intensive Care Unit","volume":"39","author":"Jackson","year":"2018","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_12","unstructured":"Tacconelli, E. (2017). Global Priority List of Antibiotic-Resistant Bacteria to Guide Research, Discovery, and Development of New Antibiotics, WHO."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s10096-013-1814-z","article-title":"Independent Risk Factors for the Co-Colonization of Vancomycin-Resistant Enterococcus Faecalis and Methicillin-Resistant Staphylococcus Aureus in the Region Most Endemic for Vancomycin-Resistant Staphylococcus Aureus Isolation","volume":"32","author":"Hayakawa","year":"2013","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Villodres, \u00c1., Mart\u00edn-Gandul, C., Pe\u00f1alva, G., Guisado-Gil, A.B., Crespo-Rivas, J.C., Pach\u00f3n-Ib\u00e1\u00f1ez, M.E., Lepe, J.A., and Cisneros, J.M. (2021). Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review. Antibiotics, 10.","DOI":"10.3390\/antibiotics10060680"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"van Dulm, E., Tholen, A.T.R., Pettersson, A., van Rooijen, M.S., Willemsen, I., Molenaar, P., Damen, M., Gruteke, P., Oostvogel, P., and Kuijper, E.J. (2019). High Prevalence of Multidrug Resistant Enterobacteriaceae among Residents of Long Term Care Facilities in Amsterdam, the Netherlands. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0222200"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Blom, A., Ahl, J., M\u00e5nsson, F., Resman, F., and Tham, J. (2016). The Prevalence of ESBL-Producing Enterobacteriaceae in a Nursing Home Setting Compared with Elderly Living at Home: A Cross-Sectional Comparison. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1430-5"},{"key":"ref_17","unstructured":"(2021, November 28). Cyprus Ministry of Health-Antimicrobial Resistance and Nosocomial Infections (Greek), Available online: https:\/\/www.moh.gov.cy\/moh\/moh.nsf\/All\/6B4121829D8502A5C2257C210026E74C."},{"key":"ref_18","first-page":"1","article-title":"Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC)","volume":"52","author":"Sehulster","year":"2003","journal-title":"MMWR Recomm. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"9637","DOI":"10.1038\/s41598-019-45886-6","article-title":"Whole Genome Sequencing Revealed New Molecular Characteristics in Multidrug Resistant Staphylococci Recovered from High Frequency Touched Surfaces in London","volume":"9","author":"Cave","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1002\/bimj.19650070312","article-title":"Sampling Techniques, 2. Aufl. John Wiley and Sons, New York, London 1963. Preis s","volume":"7","author":"Heinisch","year":"1965","journal-title":"Biom. Z."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2379","DOI":"10.1128\/JCM.39.7.2379-2385.2001","article-title":"Potential Impact of the VITEK 2 System and the Advanced Expert System on the Clinical Laboratory of a University-Based Hospital","volume":"39","author":"Sanders","year":"2001","journal-title":"J. Clin. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1093\/jac\/dkg234","article-title":"Comparative Evaluation of the VITEK 2 Advanced Expert System (AES) in Five UK Hospitals","volume":"51","author":"Barry","year":"2003","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_23","unstructured":"The European Committee on Antimicrobial Susceptibility Testing (2021, November 28). Breakpoint Tables for Interpretation of MICs and Zone Diameters. 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