1. Dr. Nikhilesh Todkari

2.  Study carried out to assess  Presence of potential pathogens on necktie  frequency of laundering of ties  attitude of doctors on not wearing a tie  Potential pathogens included  S.aureus  Gram-negative bacteria  VRE

3. 1. Questionnaire  Grade and speciality  Frequency of laundered necktie  Preference of wearing a tie at work 2. Incubation Necktie swabbed Columbia blood agar used Incubation at 37 degrees for 48h.

4.  1/3 (95/265) of all male doctors took part  NCHDs (61%) vs Consultants (13%) GradeNumberPathogens present Objection of not wearing a tie Intern141 (7%)5 (36%) SHO144 (29%)1 (7%) Registrar498 (17%)9 (18%) Consultant184 (22%) Total9517 (18%)19 (20%)

5.  Pathogens  Skin flora (CoNS, dipetheroids,micrococci) found on ALL ties.  10 ties - S.aureus  7 MRSA  3 MSSA  3 ties - mixture of Gram-negative bacilli and S.aureus  VRE not detected on any tie  NO significant association between doctor’s grade and prsence of pathogens.

6.  55% (52/95) NEVER laundered their tie.  Only 15/95 had laundered tie in past 2 months  No relationship between laundering of ties and number of pathogens.  Majority of doctors 81% would be happy not to wear a tie to work.

7.  Presence of skin flora on ties suggests they are handled regularly  Laundering of ties has no impact on bacterial colonisation  Majority of doctors surveyed had no objection to not wearing a tie.  Is it time to hang the tie?