According to a review published online in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America (SHEA), proper laundering and handling are critical for achieving and maintaining hygienically clean quality of healthcare fabrics and textiles delivered to the point of care.
Lynne Sehulster, PhD, an infectious disease epidemiologist at the Centres for Disease Control and Prevention and lead author explains how they examined evidence that suggested that current industrial laundry processes were sufficient to interrupt patient-to-patient transmission via clean healthcare textiles (HCT) and that no evidence of microbial carry-over from one patient to the next for patient-care textiles was found when proper textile management and laundering specifications were used.
Association between outbreaks of infectious disease and laundered HCT were found to be rare and only 12 such outbreaks have been reported in the last four decades. These outbreaks were due to inadvertent exposure of clean HCTs to environmental contamination.
"Current infection prevention strategies for laundering and handling HCT appear to be adequate in preventing healthcare-associated infections, provided that every step is taken to maintain the hygienic quality of HCTs prior to use,” said Sehulster.
However, he does point out that any outbreaks linked to HCT need to be closely evaluated in order to successfully pinpoint the root of the problem. It may not be sufficient to simply conduct microbial sampling of laundered textiles and conclude that the laundry process is to blame. Instead, it is important to evaluate the distinct operations of the laundry-handling process.
Based on the review, the authors recommend optimal prevention strategies including:
- Adherence to Standard Precautions (gown and gloves) and minimal textile agitation when handling contaminated laundry in isolation rooms
- Careful packaging of offsite laundries prior to transportation to prevent inadvertent contamination from dust and dirt.
- Storage of laundered HCT in a manner that ensures they remain dry and free from soil contamination.
- Use of a disinfecting laundry chemical in case of any alterations in water temperature, agitation, chemical type and concentration and duration of laundering cycle.
- Use of laundry additives, such as hydrogen peroxide, peracetic acid and acetic acid for extra disinfection for short wash cycles of HCT or for those laundry situations in which chlorine bleach is not indicated.
- Use of industrial laundering as it offers more control of the process and offers more choices of detergent and laundry additives compared to home laundering.
- Maintaining optimum temperature, relative humidity, and moisture control in storage areas to prevent microbial proliferation.
Sehulster also suggests that more studies should be conducted to demonstrate an impact on healthcare-associated infection incidence and increased patient safety.
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