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Hospital Bed Sheets Might Spread a Serious Gastrointestinal Disease

A new study finds signs of a tough bacteria at a hospital laundry facility.

By Nathan Collins


(Photo: Topical Press Agency/Getty Images)

Clostridium difficile is truly nasty—the Centers for Disease Control and Prevention notes the bacteria causes “immense suffering” and infects close to half a million Americans a year, resulting in around 15,000 deaths. For years, researchers thought the disease was spread primarily patient-to-patient within hospitals, but a new study suggests at least one other possible source: the hospital laundry.

Historically, patients contracted the bacteria (C. diff for short) during inpatient care, particularly during long stays and after taking antibiotics: C. diff is naturally resistant to a number of standard antibiotics, so killing off other bacteria with those drugs only leaves more room and resources for it to grow. C. diff is also very hard to kill with standard cleaners—alcohol, for example, doesn’t work—so if a patient has the disease, it’s easy for it to stick around on sinks, floors, toilets, and beds, waiting to infect the next patient, doctor, or nurse who comes in contact with those surfaces.

Still, C. diff exists outside hospitals as well, and it’s spread primarily through infected patients’ feces—an observation that led University of Washington Professor of Environmental and Occupational Health Sciences Marilyn Roberts and her colleagues to wonder whether some contamination could come from facilities that handle that most typical of soiled hospital surface, the linens.

C. diff is naturally resistant to a number of standard antibiotics, so killing off other bacteria with those drugs only leaves more room and resources for it to grow.

To find out, they went to the University of Washington Consolidated Laundry facility, which processes around 300,000 pounds of laundry each week from six Seattle-area hospitals, 30 clinics, and the Washington National Primate Research Center. Roberts and her team visited the site four times over the course of a year and collected samples from 60 spots, including areas where laundry was soiled, washers, and clean laundry folding areas.

In all, 27 samples, or about 11 percent, tested positive for C. diff, almost all in “dirty” areas where laundry was received and sorted, and primarily in spring and fall, consistent with seasonal variations in C. diff infections. That finding, incidentally, has led to additional disinfection measures at the facility.

The researchers can’t say whether C. diff contamination at the laundry site actually got anyone sick—they didn’t track infection or illness in any of the employees—but it remains a possibility. An initial survey found C. diff on the door of a truck that transports laundry to and from the facility.

“Very little data on environmental contamination by C. difficile, outside of clinical settings, exists in the literature,” Roberts and her colleagues write. “The study suggests that soiled clinical linens are a potential source of C. difficile surface contamination and more studies need to be done to determine if this type of contamination is a risk to laundry workers.”