CLIN IC A L NE WS
Are the Towels in Your Hospital Really Clean? Investigators Find Dangerous Microbes By ALISON McCOOK
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lean towels are clean, right? Several years ago, a group of investigators set out to answer that question. They collected three cleaned towels from 10 Arizona hospitals, submerging each towel in buffered peptone water to extract microbes. They wrung out each towel, collected the broth and examined it for signs of potentially dangerous microbes. The investigators found them. More than 90% of the towels contained viable microbes, including 3% with the potentially dangerous bacteria Escherichia coli. Furthermore, more than half of the buckets used to soak towels in disinfectants—the very containers designed to clean the towels—harbored viable bacteria, including those that form spores (Am J Infect Control 2013;41[10]:912-915). The results are among a body of research that points to a troubling trend: The products used to clean medical facilities may be contributing to their contamination. Now, researchers are asking themselves how to do a better job of cleaning hospital cleaning products.
‘We’re cleaning up after people, and people leave behind a lot of stuff—everything from small bits of human skin and hair to bacteria, fungi and viruses ... In some cases, the contamination level was too high to count with the traditional and molecular methods we were using.’ —K. Mark Wiencek, PhD In the 2013 study, the researchers examined reusable cloths made of cotton and of microfiber, common materials used in cleaning products. Both were contaminated. Roughly 10 years ago, microfibers came onto the market, promising to do a better job of picking up soil and weighing less than cotton, the typical material of cleaning products such as mops and rags (Am J Infect Control 2007;35[9]:569-573).
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Since then, hospitals rapidly added them to their roster of cleaning products. But then they came across a dilemma: The laundry techniques that kill microbes—bleach and hot water— also destroy the delicate microfibers. The gentle cleaning process that microfibers need doesn’t always destroy the contamination on the surface of used cleaning products. Now that the world is dealing with an ongoing COVID-19 pandemic, adopting the best products and practices for cleaning has become even more crucial. The situation has left facilities scrambling for solutions. “We’re finding lots of contamination in the very tools we are using to clean,” said K. Mark Wiencek, PhD, the lead microbiologist at Contec, Inc., a company headquartered in Spartanburg, S.C., that manufactures cleaning supplies. “As a result, we are faced with this conundrum of how to properly decontaminate these towels and mops without destroying the textile.”
A Fine Mess A microfiber mop that’s been used to clean a hospital floor is, simply put, pretty gross. “We’re cleaning up after people, and people leave behind a lot of stuff—everything from small bits of human skin and hair to bacteria, fungi and viruses,” Dr. Wiencek said. He and his colleagues have repeated the 2013 experiment, testing mops and towels from hospitals after laundering. “In some cases, the contamination level was too high to count with the traditional and molecular methods we were using,” he said. Microfiber initially works better than cotton, but after multiple washes and if laundered improperly microfiber may not perform as well (Am J Infect Control 2010;38[4]:289-292), noted Karen deKay, MSN, RN, CNOR, CIC, a perioperative practice specialist at the Association of periOperative Registered Nurses. Most facilities likely use a variety of materials to clean between patients, she said. In the perioperative environment, for instance, most places employ single-use disinfectant cloths made of continued on page 22
