Dangerous bacteria survive hospital laundries

Diarrhoea-causing bug SURVIVES high temperatures and industrial-strength BLEACH used in hospital laundries prompting fears NHS disinfection guidelines are inadequate

• C.diff spores are present at levels sufficient to cause an outbreak after washing
• Sheets are often rented out by companies between hospitals and care homes
• May explain why outbreaks occur without any obvious source of infection
• NHS sets a standard of no pathogens on contaminated sheets after washing

NHS disinfection guidelines may be inadequate because they do not kill diarrhoea-causing bugs, research suggests.

C.difficile spores purposely placed onto bed sheets survived the technique used throughout NHS hospitals.

Tests showed industrial-strength bleach and high washing machine temperatures of 75°C for at least three minutes only killed 35 per cent of the spores.

These sheets are often rented out by companies between multiple hospitals and care homes, which may explain why patients can be struck by infections without any obvious source.

The NHS sets a standard of no dangerous bacteria remaining on contaminated sheets after they have been washed.

Bacteria that cause diarrhoea survive the high temperatures and industrial-strength bleach that is used to clean bed sheets in hospital laundries, research suggests (stock)

Researchers at De Montfort University contaminated cotton sheets with C.difficile spores for the study.

These sheets were then put in a washing machine with an industrial-strength bleach detergent, along with other pieces of bacteria-free fabric.

After analysing the bacteria that remained, results suggest two strains of C.difficile spores survived the washing process.

One of these strains was present at up to nine colony-forming units (cfu) per 25cm².

Cfu is the number of bacteria in a given area that has the ability to multiply and spread.

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Surfaces have previously been classed as contaminated with C.difficile if they contain just 0.25 cfu per 25cm².

C.difficile spores also transferred from the contaminated sheets onto the sterile pieces of fabric.  

WHAT IS C. DIFF?

Clostridium difficile, also known as C. diff, is a bacterium that can infect the bowel and cause diarrhoea.

The infection most commonly affects people who have recently been treated with antibiotics, but can spread easily to others.

C. difficile infections are unpleasant and can sometimes cause serious bowel problems, but they can usually be treated with another course of antibiotics.

Source: NHS Choices

The scientists then analysed sheets that had been used by patients who were diagnosed with C.difficile.

These sheets were also put in a washing machine and then through a drying cycle according to the NHS’ healthcare laundry policy.

Drying involved pressing the sheets at 175°C with four bars of pressure for three seconds.

Before being washed, these sheets had an average spore count of 51cfu per 25cm².

After being washed and dried, this count reduced but only by 35 per cent to 33cfu per 25cm².

The study was published in the journal Infection Control & Hospital Epidemiology. 

‘Both laundering processes failed the microbiological standards of no pathogenic bacteria remaining,’ the researchers wrote in the journal.  

Lead author Dr Katie Laird added: ‘The findings of this study may explain some sporadic outbreaks of C. difficile infections in hospitals from unknown sources’.

Hospital sheets are often rented out by businesses that collect, wash and redistribute them between hospitals and care homes.

The researchers are working with the Textiles Services Association to determine the best way of removing C.difficile spores from bed sheets.   

NHS Improvement has been approached for comment.  

C.difficile causes watery diarrhoea, which can lead to severe dehydration. These infections are common in hospitals among already ill patients.

This was thought to be due to staff easily spreading the bacteria if their hands are contaminated. 

Research released earlier this year even suggested C.difficile could spread by hand dryers that ‘suck in’ bacteria from flushing toilets.

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