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Wednesday, December 11, 2013

Environmental Contamination - is the cloth more concerning than the patient?

Until now, I have never really given much thought to what may or may not transpire when doing laundry.  Certainly, I KNOW if you want to keep your whites white, you DO NOT want that errant piece of red clothing to be part of the white load.  Just as my mother had taught me, I separate laundry to have a linens load, a whites load, a colours load etc.  She DID NOT, however, teach me to have a separate underwear load.  If you keep reading you'll see where I'm going.....

Last week's blog Cotton - it absorbs more than just water focused on how cotton cloths absorb Quats and therefore impact disinfection.  It gets worse, SO MUCH worse. Gerba et al recently published a study in AJIC titled "Microbial contamination of hospital reusable cleaning towels".  The focus was not on what was found on the cloth AFTER using, but what was found on the cloth AFTER laundering and therefore assumed CLEAN!!!  Ten (10) hospitals participated in the study - 8 of which used cotton cloths, 2 of which used microfiber cloths.  Of the 10 facilities, 9 used a Quat as their daily disinfectant.   After last week's blog we know that's a potential infection prevention and control nightmare.  After sampling the "CLEAN" cloths Gerba and his team found that 93% of the cleaning cloths contained viable microorganisms EVEN AFTER LAUNDERING!

The microorganisms that were found on the offending cloths included bacteria that play a significant role in HAIs such as Klebsiella spp, Pseudomonas spp and Serratia spp.  The gross factor (at least to me) was the fact they found coliform bacteria on the cloths...for those who do not know, coliform bacteria are universally present in large numbers in the feces of warm-blooded animals (and humans). Basically there was POOP on the cloths!

The researchers did find that there was a significant difference in the contamination level found after laundering the cotton and microfiber cloths with microfibers showing the highest level of bacterial adhesion.  Previously published data has supported the fact that bacteria adhere more strongly to microfiber cloths which can have the impact of spreading pathogens to different surfaces as the microfiber cloths are continually used.  In the end, Gerba and his colleagues found that typical laundering practices are not sufficient to remove viable pathogens from cleaning cloths.  What they could not determine was if the contamination was due to a breakdown in the laundering process or if the cloths get contaminated from storage and handling (I am going to hope it's the latter). The end result is that the Infection Preventionists and Environmental Services staff need to consider that cleaning cloths could be a potential reservoir for nosocomial pathogens.

I will admit, I have always questioned the laundering process at hotels and so I NEVER let the bed covers touch my face.  I think perhaps now, with the knowledge that coliforms can be found on cleaning cloths after laundering I am going to have to rethink how I sort my laundry.  Effective immediately, underwear are GOING TO BE LAUNDERED ON THEIR OWN....need I say more?

Bugging Off!



1 comment:

  1. I read with interest your article panicking about clothing. I lecture on my more raw moments that :1. We all share bugs within our household, so your overall flora (microbiome) would be similar to our spouse and children. 2. We all have fecal flora on us due to the nature of our own pericare after defecating. By the time we replace our clothing and then wash our hands, we will have applied a bit of bugs to our trousers, belt, etc. All a part of being on the planet earth!

    It's important to remember that some bugs are good to have around us, for example our coliform bacteria offer competition to keep other bad guys away. We really should not be too upset at ingesting coliforms as long as they are not the ‘pathogenic’ guys like Salmonella and friends. In healthcare, yes, we need to make sure the bugs are killed, and if we wash laundry at an industrial level, the souring process is supposed to handle those bugs through a rapid pH change. Most hospital, and well-processed hotel linen should be almost sterile on coming out of the ironer.

    All that said, you do make me smile with these blogs!