Survival of enterococci during hospital laundry processing

Area of Science:

• Microbiology
• Infection Control
• Environmental Hygiene

Background:

• Nosocomial enterococcal infections pose a significant public health challenge.
• Enterococci exhibit notable thermotolerance, potentially compromising standard disinfection protocols.
• Previous laboratory studies indicated survival of enterococci under recommended linen decontamination conditions.

Purpose of the Study:

• To evaluate the effectiveness of hospital laundry processes in decontaminating linen from enterococci.
• To assess the efficacy of specified time/temperature combinations against Enterococcus faecalis and Enterococcus faecium strains.
• To determine if current hospital laundry practices adequately address enterococcal contamination.

Main Methods:

• Determined the thermotolerance of 40 strains of Enterococcus faecalis and Enterococcus faecium.
• Assessed the reduction of enterococci using UK Department of Health recommended time/temperature combinations (3 min at 71°C or 10 min at 65°C).
• Conducted experimental decontamination trials in 10 operational hospital laundries using artificially contaminated linen.

Main Results:

• Only two of 40 enterococcal strains showed a reduction greater than 10^5 under laboratory conditions using specified parameters.
• Successful decontamination of enterococci from artificially contaminated hospital linen was demonstrated in all 10 working laundries.
• The primary decontamination of enterococci occurred during the washing stage of the laundry process.

Conclusions:

• Despite their thermotolerance, standard hospital laundry washing processes are effective in decontaminating linen from enterococci.
• The time/temperature combinations outlined in HSG(95)18 are adequate for enterococcal decontamination within the context of working hospital laundries.
• Hospital laundry procedures play a crucial role in controlling the spread of nosocomial enterococcal infections.