Employees in healthcare who wash their work clothes at home could unknowingly contribute to the spread of antibiotic -resistant infections in hospitals. Despite compliance with the washing guidelines, not all germs, as a study shows. As a result, potential pathogens remain in clothing, store themselves in the machine and transfer themselves to other textiles with each wash. Among these microbes are also those with antibiotic resistance genes. These dangerous germs can then spread through the uniforms of hospital employees and infect patients.
Microbes that trigger infectious diseases and frolic in hospitals are a major problem for the health of the patients treated there – especially because many of these bacteria are resistant to antibiotics. The hospital germs are spread over the air, body fluids and skin contact, but also through the clothing of the staff and patients in the buildings and transferred to other people. To prevent this, not only hands and surfaces are disinfected in the hospital, but also washed the clothes regularly. However, many nurses, nurses, doctors and other employees in British and US healthcare clean their work clothes at home in commercially available washing machines. Washing regulations apply, but can these machines really remove the dangerous germs and prevent their spread sufficiently?
Washing machines do not clean sufficient
Researchers around Caroline Cayrou from De Montfort University in Leicester have followed this question. To do this, they wash up uniforms from health care staff with six different models of household washing machines. They deliberately contaminated the clothing beforehand with the Enterococcus faecium intestinal germ. For washing, they used various detergents and two programs: a quick rash and a normal cleaning program, each at 60 degrees Celsius. They then analyzed whether Enterococcus germs were still in the clothes.
The experiment showed that with the standard program in two of six washing machines, the fabric samples were not sufficiently decontaminated and disinfected from the laundry. With the quick rash, there were even three out of six machines. The reason: the desired temperature of 60 degrees was not reached in the devices and/or not long enough. “Even if employees in the healthcare system believe they would be their uniforms [wie vorgeschrieben] Disinfecting at 60 degrees Celsius for ten minutes is the likelihood that the device used will not perform the expected performance, ”the researchers write. According to this, about half of all washing machines are not suitable for removing hospital germs from the clothing of the staff in accordance with applicable regulations.” In addition, the water hardness can affect the effectiveness of the detergent, “said the team. The location of the machines also plays a role.
But do the germs stay in the machine after the laundry? In order to find out, the team took the drawback samples from biofilms from twelve washing machines: in the detergent drawer and under the rubber seal of the drum near the door. Cayrou and their colleagues examined the types of DNA, which bacterial species were romping in these samples. The analysis showed that germs had collected in eight out of twelve washing machines. Among these microbes were bacteria that can cause diseases- such as mycobacteria, pseudomonas or acinetobacter species- and those that wear antibiotic resistance genes and therefore cannot be treated with antibiotics. Some of the bacteria, including Staphylococcus Aureus and Klebsiella Pneumoniae, also developed a resistance to household detergents, which increased their resistance to certain antibiotics or produced new resistance, as further tests showed. “In a remarkable case, a previously antibiotic -sensitive tribe of Staphylococcus aureus developed an antibiotic resistance and practically became MRSA without ever being exposed to antibiotics,” reports senior author Katie Laird.
New washing rules for work clothes?
The researchers conclude that the biofilms in washing machines are an environment that promote antibiotic resistance. According to this, many household washing machines are not only not suitable for decontamining the clothing of healthcare staff, but they even actively contribute to the development and spread of hospital infections and antibiotic resistance, the researchers conclude. “If we are serious about the transfer of infectious diseases via textiles and the fight against antibiotic resistance, we have to rethink how we wash the clothing of our healthcare employees,” write Cayrou and their colleagues.
In their view, the washing guidelines for health care employees must be revised in order to control the spread of pathogens and to improve patient safety. The guidelines could, for example, stipulate that the washing machines use programs with a higher temperature and longer duration at home and are also cleaned more regularly so that no germs can accumulate in them. Alternatively, clothing in industrialose machines could be washed in health facilities. This is the case in Germany anyway. “Great Britain is the only country in Europe in which the uniforms of the nurses are regularly washed at home,” explains Laird.
Source: Caroline Cayrou (de Montfort University) et al.; Plos one, DOI: 10.1371/Journal.pone.0321467