Viruses, bacteria, yeast, and even fungi. Despite your best efforts, all of these little bugs at some point will colonize your personal space and start an infection.  From being sneezed on by a contagious co-worker, to eating contaminated food, to sharing a gym locker with the wrong person, there are a million different ways for you to catch one of these critters. But have you ever considered that the necktie worn by your doctor could be one of them? A couple of different studies out of the UK have examined that very question.

Hospitals are typically thought of as places of healing, but there's always a chance of picking up a new infection while you're admitted.  A study by Dr. M. Dixon looked at this problem of hospital acquired infections specifically in an intensive care unit at Addenbrooke's Hospital (Intensive Care Medicine, 2000 vol 26 page 250).  Instruments like stethoscopes or even ink pens are usually thought of as being vectors for infection agents to move from one patient to another, but Dr. Dixon wanted to see if neckties could also be involved since they too are present when each patient is examined but often are rarely cleaned.  Specifically looking for bacteria, he cultured the tips from traditional long neckties from all five male members of the hospital's intensive care staff and found all five contaminated at some level.  Three of the five ties showed high levels of bacteria like Staphylococcus citreus which can cause skin and other types of infections.  It's easy to imagine how a doctor bending over to examine a patient in a bed could have their tie swing down and either pick up an infections agent or leave one behind.

A second study looked at similar issues of contamination of neckties with bacteria, but this time in a little more gross way (British Medical Journal, 1993 vol. 307; page 1582).  Eighteen doctors in a labor and delivery unit were each given a clean tie, either a traditional long necktie or a bow tie, and asked to wear then for three typical days at work seeing patients and delivering babies  Surprisingly only twelve of the eighteen physicians actually completed the study with one doctor keeping the free tie and never contacting the study team again!  By the end of a single working day, bacteria such as Enterococcus faecalis were found on most of the bow ties and all the traditional neckties-the E. faecalis usually found in the intestinal tract or in the female reproductive tract.  That E. faecalis.  By the end of the third day, all the bow ties were contaminated as well.  Finding this amount of bacterial contamination is even more surprising given that all doctors in the study claimed to wear lab coats at least some of the time to protect them and their clothes from the daily hazards of their OB/GYN job including blood, amniotic fluid, urine, and feces.  Luckily Enterococcus faecalis doesn't typically cause disease, but I'm still guessing most mothers still wouldn't want their doctors walking into the delivery room with those friends in tow.

So the next time you visit your doctor, ask them when they had their necktie last cleaned. It's one item that medicine may be able to do without.