Browsing by Author "Tarrant, Joanna"

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    Clostridium difficile spores and healthcare laundry policy: How clean is your hospital bed?
    (Society for Applied Microbiology, 2014) Tarrant, Joanna; Jenkins, R. O.; Laird, Katie
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    From Ward to Washer: The Survival of Clostridium difficile spores on Hospital Bedsheets through a Commercial UK NHS Healthcare Laundry Process
    (Cambridge University Press, 2018-10-16) Jenkins, R. O.; Laird, Katie; Tarrant, Joanna
    Objective: to quantify the survival of Clostridium difficile spores on hospital bedsheets through the UK NHS healthcare laundry process (Health Technical Memorandum (HTM) 01-04) in vitro and from C. difficile patient’s bedsheet through the commercial laundry. Methods: C. difficile spores were inoculated onto cotton sheets and laundered through a simulated Washer Extractor (WE) cycle using an Industrial bleach detergent with Sodium Hypochlorite 15%and peracetic acid sour 14% (Acetic acid and Hydrogen peroxide, pH 2-4 ). C. difficile naturally contaminated hospital sheets survival was also assessed through a WE, drying and finishing cycle at a commercial laundry. Patients: Naturally contaminated C. difficile bedsheets were taken from patients’ beds that had previously been diagnosed with C. difficile infection (CDI) and were on an isolated C. difficile ward. Results: The simulated WE cycle, with an industrial detergent, demonstrated survival of two strains of C. difficile NCTC 11209 (0-4 cfu/25cm2) and ribotype 001/072 (0-9 cfu/25cm2). Before laundering naturally contaminated bedsheets had an average spore load of 51 cfu/25cm2 and after washing, drying and finishing it was 33 cfu/25cm2, pre and post wash the C. difficile strain was identified as ribotype 001/072. Both the simulated and in situ laundering process failed the microbiological standards of no pathogenic bacteria. Conclusions: This study shows that C. difficile spores are able to survive laundering through a commercial WE and may be contributing to sporadic outbreaks of CDI. Further research to establish exposure of laundry workers, patients and the hospital environment to C. difficile spores from bedsheets is required.
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    How clean are your Hospital Beds?,
    (American Society for Microbiology, 2015) Laird, Katie; Jenkins, R. O.; Tarrant, Joanna
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    Survival of Clostridioides difficile spores in thermal and chemo-thermal laundering processes and influence of the exosporium on their adherence to cotton bed sheets
    (Oxford University Press, 2022-08-18) Owen, Lucy; Laird, Katie; Jenkins, R. O.; Tarrant, Joanna; Smith, Laura J.
    Clostridioides difficile spores were previously demonstrated to survive industrial laundering. Understanding interactions between heat, disinfectants and soiling (e.g. bodily fluids) affecting C. difficile spore survival could inform the optimization of healthcare laundry processes. Reducing spore attachment to linen could also enhance laundering efficacy. This study aimed to compare the sensitivity of C. difficile spores to heat and detergent, with and without soiling and to investigate adherence to cotton. Survival of C. difficile spores exposed to industrial laundering temperatures (71–90°C), reference detergent and industrial detergent was quantified with and without soiling. The adherence to cotton after 0 and 24 h air drying was determined with the exosporium of C. difficile spores partially or fully removed. Clostridioides difficile spores were stable at 71°C for 20 min (≤0·37 log10 reduction) while 90°C was sporicidal (3 log10 reduction); soiling exerted a protective effect. Industrial detergent was more effective at 71°C compared to 25°C (2·81 vs 0·84 log10 reductions), however, specifications for sporicidal activity (>3 log10 reduction) were not met. Clostridioides difficile spores increasingly adhered to cotton over time, with 49% adherence after 24 h. Removal of the exosporium increased adherence by 19–23% compared to untreated spores. Further understanding of the role of the exosporium in attachment to cotton could enhance spore removal and aid decontamination of linen.
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    Survival of Clostridium difficile spores on cotton during healthcare laundering
    (De Montfort University, 2017-12) Tarrant, Joanna
    The transmission of Clostridium difficile infection (CDI) is mediated by spores, which are highly resistant to heat and disinfectants. The healthcare laundry policy, Health Technical Memorandum 01-04 Decontamination of linen for health and social care, provides minimum disinfection conditions and microbiological standards for laundered linen: no bacteria on previously sterile de-sized textiles, >5 log(10) reduction of a thermotolerant species of bacteria and <100 cfu with no pathogenic bacteria on sampled linen. Quantification of the survival of spores, from hospital sheets (100% cotton) naturally contaminated with C. difficile spores were laundered in a washer extractor (WE) at a commercial laundry; they failed the microbiological standards. Similar results were achieved in a simulated healthcare WE cycle. The industrial detergent used failed the test for sporicidal activity (BS EN 13704), with a 2.81 log(10) reduction in spores. The method of recovering spores from swatches was important; in the presence of soiling, agitation by vortexing (4.48 log(10) cfu/25cm2) was more effective than stomaching (4.2 log(10) cfu/25cm2, p≤0.05). Spore adherence to cotton occurred over time, with 0% (0 hours) and 51% (24 hours) adherence; adherence decreased to 34% (24 hours) after exosporium removal, suggesting a role in spore adherence to cotton. The possibility cannot be discounted that low-level spore survival on processed linen may be contributing to environmental contamination and asymptomatic carriage.