C. diff transmission via soiled linen

Feb. 20, 2017

Dear Editor,

The article, “Latest Report Linking Dirty Laundry With C.diff Highlights Healthcare Laundry Facility’s Role In Infection Prevention, Patient-Safety” featured in your December 9, 2016 Daily Update Enewsletter, omitted several key facts and helped fuel misleading impressions of hospital laundry cleanliness. Several key areas of the mentioned study, which was published in FEMS Microbiology Letters, should be pointed out:

  • No significant contamination was found on the clean side of the subject laundry.
  • It was expected that the soiled linen area would be more vulnerable to contamination than clean areas.
  • No conclusion was reached regarding soiled linen contamination as a risk to laundry workers.

In processing hundreds of millions of soiled healthcare linens each year for decades, the number of documented cases of contamination or transfer of C. diff or any other transferrable disease or bacteria to an employee, patient or healthcare provider has no statistical bearing.

The research fails to mention laundry processes’ effectiveness in eliminating bacteria. TRSA’s Hygienically Clean program has tested nearly 3,000 laundered items since 2013, roughly 25 percent specifically for clostridium and none have revealed any of this bacterium.

The study located traces of C. difficile spore-forming bacteria in the soiled-linen area of the subject laundry and virtually zero in the “COG washing area” of the subject laundry facility, identifying the latter as “dirty” since linens were being processed there. In awarding certification, inspections ensure that any facilities processing healthcare linens have functional separation between dirty and clean linen processing areas to minimize risks associated with contamination.

Commercial laundries undertake strict precautions to minimize risk of any contamination. The majority of certified healthcare laundries worldwide undergo periodic inspection to ensure best practices and processing protocols are followed and clean linens are randomly tested. Laundries processing healthcare linens understand the importance of following strict guidelines for time, temperature, chemical and agitation levels in the cleaning process.

We appreciate the grave concerns of C. difficile contamination. TRSA and other commercial laundry organizations work closely with infection control and prevention experts regarding the cleanliness of laundry facilities, linens and the safety of workers. Your readers should be made aware of these practices, not stories that misleadingly create false alarms and ultimately distract attention from patient care.

Joseph Ricci, President and CEO, TRSA