Bath towels, dish cloths, T-shirts and socks made of
cotton have one thing in common - absorbency.
Whether it is wicking the water off after we shower, the sweat during
and after a workout or wiping up the spills of water or milk we so frequently
seem to have at my dinner table, many of us turn to cotton in some form.
While microfiber is making in-roads, cotton terry cloth
towels are still very prevalent as the cloth of choice for cleaning and
disinfection within healthcare facilities.
Infection Prevention and the Product Selection Committee spend hours
reviewing disinfecting products weeding through the attributes of the various
chemistries, ensuring that they have the list of efficacy claims (the kill
list) to meet the facilities' needs etc.
However, in focusing on what a product kills is there any consideration
as to what impact the materials housekeeping uses to clean with will have on
the efficacy of the product? I think
not.
towels are still very prevalent as the cloth of choice for cleaning and
disinfection within healthcare facilities.
Infection Prevention and the Product Selection Committee spend hours
reviewing disinfecting products weeding through the attributes of the various
chemistries, ensuring that they have the list of efficacy claims (the kill
list) to meet the facilities' needs etc.
However, in focusing on what a product kills is there any consideration
as to what impact the materials housekeeping uses to clean with will have on
the efficacy of the product? I think
not.
In the October 2013 edition of AJIC, Koenig et al
published an article titled "Decreased activity of commercially available disinfectants containing quaternary ammonium compounds when exposed to cotton towels". As noted in the study
poorly cleaned surfaces have been identified as being a potential reservoir for
pathogens and may be the cause of many healthcare associated infections. Numerous studies have shown that effective
cleaning (and disinfection) is necessary to reduce the risk of HAIs. Disinfectants are an important aspect in
reduction of pathogens so reduction in performance of a disinfectant could play
a significant role in allowing transmission to occur.
published an article titled "Decreased activity of commercially available disinfectants containing quaternary ammonium compounds when exposed to cotton towels". As noted in the study
poorly cleaned surfaces have been identified as being a potential reservoir for
pathogens and may be the cause of many healthcare associated infections. Numerous studies have shown that effective
cleaning (and disinfection) is necessary to reduce the risk of HAIs. Disinfectants are an important aspect in
reduction of pathogens so reduction in performance of a disinfectant could play
a significant role in allowing transmission to occur.
The truth is that is the negative impact on efficacy of
Quats by either dilution with hard water and/or exposure to cotton cloths has
been known for some time. Koenig et al
investigated the reduction of Quat concentration resulted from the use of
cotton and microfiber cleaning towels and the impact this reduction would have
on disinfectant performance. The results
were indeed scary.
Quats by either dilution with hard water and/or exposure to cotton cloths has
been known for some time. Koenig et al
investigated the reduction of Quat concentration resulted from the use of
cotton and microfiber cleaning towels and the impact this reduction would have
on disinfectant performance. The results
were indeed scary.
First the good news, it would appear in this study that
exposure to microfiber cloths did not have an impact on the Quat concentration
and that the products tested retained their full germicidal efficacy. Cotton on the other hand did not fare so well. Exposure of the Quat products tested resulted
in a reduction of Quat concentration by 88.9% within 30 seconds of being
exposed to cotton! Excuse ME!? That would leave only 11.1% of the actual
concentration of Quat needed, tested and approved by the EPA to achieve
disinfection. In fact, when the
researchers tested the efficacy of the Quat solution after exposure to cotton
towels they all failed! They were unable
to meet the level of kill needed to be registered by the EPA as a hospital
grade disinfectant.
exposure to microfiber cloths did not have an impact on the Quat concentration
and that the products tested retained their full germicidal efficacy. Cotton on the other hand did not fare so well. Exposure of the Quat products tested resulted
in a reduction of Quat concentration by 88.9% within 30 seconds of being
exposed to cotton! Excuse ME!? That would leave only 11.1% of the actual
concentration of Quat needed, tested and approved by the EPA to achieve
disinfection. In fact, when the
researchers tested the efficacy of the Quat solution after exposure to cotton
towels they all failed! They were unable
to meet the level of kill needed to be registered by the EPA as a hospital
grade disinfectant.
I'm not saying that Quats are bad. BUT, this study certainly highlights the fact
that we need to take more into consideration than just what a product kills,
what the cost of a product is and what the material compatibility of a product
is. The impact and cost to a facility
due to HAIs is very real. I think Koenig
et al have done an excellent job in highlighting the fact that when choosing a
disinfectant the process by which a disinfectant will be used must also be
taken into consideration and further research into potential interactions
between the disinfectant and cloth choose to apply the product also needs to be
considered. Particularly if concerned
about reducing HAIs and providing the safest environment for our patients as
possible.
that we need to take more into consideration than just what a product kills,
what the cost of a product is and what the material compatibility of a product
is. The impact and cost to a facility
due to HAIs is very real. I think Koenig
et al have done an excellent job in highlighting the fact that when choosing a
disinfectant the process by which a disinfectant will be used must also be
taken into consideration and further research into potential interactions
between the disinfectant and cloth choose to apply the product also needs to be
considered. Particularly if concerned
about reducing HAIs and providing the safest environment for our patients as
possible.
If you use Quats at your facility, I hope you'll run down
to Environmental Services to see what type of cloth is being used. Perhaps your current VRE or MRSA outbreak etc
is not due to poor cleaning, but due to the fact that while the name of the
product may contain the word "Disinfectant" the cleaning process you
are using may counteract and inhibit the ability for disinfection to actually
occur.
to Environmental Services to see what type of cloth is being used. Perhaps your current VRE or MRSA outbreak etc
is not due to poor cleaning, but due to the fact that while the name of the
product may contain the word "Disinfectant" the cleaning process you
are using may counteract and inhibit the ability for disinfection to actually
occur.
Bugging Off!
Nicole
