Contaminated operating room boots: The potential for infection

Background: Dirty operating room boots, often contaminated with blood and other infected material, are not only a source of discontent among surgeons and other surgical personnel, but they also pose a potential risk of transmission of viral or bacterial diseases to the wearer and cleaner of the boots. Method: Operating room boots were examined for the presence of blood by visual inspection; the presence or absence of blood was confirmed by a specific biochemical test. Bacterial isolation and quantification from boots were performed with conventional methodology. Results: In this study, a spot check revealed that 44% of all operating room boots tested were contaminated with blood and that the majority were contaminated with bacteria. Sixty-three percent of surgeons using the facility had blood-contaminated boots, and a significant number of boots belonging to other surgical personnel were also contaminated with blood and bacteria normally associated with skin microbiota or the environment. Comfort shoes with perforations on their upper surface and plastic boots commonly found in operating rooms were most heavily contaminated, whereas Wellington boots and clogs had less contamination. Conclusion: The present practice of manual cleaning of boots is unsatisfactory, and it is recommended that boots be washed in automatic washing machines. (Am J Infect Control 2002;30:179-83.)