Infection Control & Hospital Epidemiology

Original Articles

Effectiveness of Low-Temperature Domestic Laundry on the Decontamination of Healthcare Workers' Uniforms

N. Lakdawalaa1, J. Phama1, M. Shaha1 and J. Holtona1 c1

a1 Centre for Infectious Diseases and International Health, Windeyer Institute of Medical Sciences, University College London, London WC1T 4JF, United Kingdom

Abstract

Objective. Most professionals in the healthcare environment wear uniforms. For the purpose of this study, we concentrated on nurses' uniforms. In the United Kingdom, many nurses are expected to launder their uniforms at home by using a domestic washing machine that frequently has low-temperature wash cycles. We have investigated whether the use of low-temperature wash cycles results in a microbiologically acceptable product to wear on the wards.

Methods. We have assessed the bioburden on uniforms before and after laundry and the effectiveness of low-temperature wash cycles and ironing on removal of methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii. We did not assess the role of tumble drying.

Results. We demonstrate contamination of uniforms by gram-negative bacteria after wash, the removal of MRSA at low-temperature wash cycles in the presence of detergent, and the eradication of gram-negative bacteria after ironing.

Conclusions. Our conclusions are that laundry in a domestic situation at 60°C (140°F) for 10 minutes is sufficient to decontaminate hospital uniforms and reduces the bacterial load by more than 7-log reduction, that items left in the pockets are decontaminated to the same extent, that the addition of either a biological detergent or a nonbiological detergent is beneficial in removing MRSA from experimentally contaminated swatches, and that uniforms become recontaminated with low numbers of principally gram-negative bacteria after laundry but that these are effectively removed by ironing.

(Received March 28 2011)

(Accepted June 30 2011)

Correspondence

c1 Clinical Microbiology, Whittington Hospital and Department of Health and Social Sciences, University of Middlesex, London NW4 4BT, United Kingdom (John.holton@whittington.nhs.uk)