Hospital linens may be source of C. diff outbreaks, study finds

Commercial laundering processes using industrial detergent and high disinfecting temperatures do not completely eliminate the presence of Clostridium difficile bacteria on hospital sheets, according to a study published in Infection Control & Hospital Epidemiology.

For the study, researchers assessed bacterial contamination before and after washing sheets naturally or artificially contaminated with C. difficile spores. In one washing process, researchers inoculated cotton sheets with C. difficile spores and washed them with sterile uncontaminated pieces of fabric using an industrial bleach detergent in a simulated washing extractor cycle.

Researchers also assessed spore survival on naturally contaminated bedsheets from C. difficile patients using the United Kingdom National Health System's healthcare laundry decontamination process. The sheets were washed with industrial detergent at a high disinfecting temperature in a commercial washer before being pressed and dried.

Neither washing process eliminated the presence of pathogenic bacteria. The U.K.'s commercial laundry process only reduced C. difficile spore counts by 40 percent.

Researchers concluded current thermal disinfection standards for hospital sheets do not adequately remove C. difficile spores. They said hospital linens could be a source of sporadic C. difficile outbreaks at healthcare facilities.

"The findings of this study may explain some sporadic outbreaks of C. difficile infections in hospitals from unknown sources, however, further research is required in order to establish the true burden of hospital bedsheets in such outbreaks," lead author Katie Laird, PhD, head of the Infectious Disease Research Group, School of Pharmacy, at De Montfort University in the U.K., told Science Daily. "Future research will assess the parameters required to remove C. difficile spores from textiles during the laundry process."

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