ARTA Study Shows Tunnel Wash Process
with Peracetic Acid Kills C.diff Spores 

Study designed to replicate the laundry process using tunnel washer
and Peracetic acid offers promising results. 

Within the healthcare setting, the human pathogen Clostridium difficile (C.diff) infects nearly 500,000 people each year and results in the deaths of 29,000. The bacterium targets those who are immune-compromised, aged, and on extended antibiotic therapies. A C.diff infection can result in a range of symptoms and diseases, including CDAD (Clostridium difficile Associated Diarrhea).
      While there is currently significant interest in housekeeping and patient room decontamination, there is less known about killing C.diff spores during the laundering of contaminated patient bedding, patient gowns/clothing, healthcare worker garments, and reusable housekeeping supplies. To meet this challenge, ARTA undertook two controlled laboratory studies designed to illustrate the impact of professional laundering processes on the destruction of C.diff spores.
      The conclusions from these two studies illustrate that (in the absence of an EPA-approved testing method specific to the laundering process), it is possible to use a modification of available methods to study C.diff spores.
      The conclusions from Study 1 reinforce beliefs specific to the decontamination of hard non-porous surfaces in healthcare settings — sodium hypochlorite is effective at the destruction of C.diff spores. These findings also reinforce legacy beliefs specific to the historical laundering process, i.e., that sodium hypochlorite bleaching is effective at decontaminating textiles. The findings also suggest that the healthcare laundry market’s conversion away from use of chlorine containing bleaches may lead to bacterial spores that survive the laundering process.
      In Study 2, focus was placed on the sequential steps employed by the modern tunnel washer laundering process and the varying physiochemical environments to which contaminated textiles are exposed. Study 2 takes the cumulative effects into consideration and demonstrates that, when taken as an aggregate, laundering contaminated healthcare linens in the absence of chlorine bleach can produce healthcare textiles rendered essentially free of C.diff spores.
      These results are instrumental in substantiating the efficacy of a laundering program which has eliminated the use of chlorine bleaches in response to the prevalence of CHG-based surgical preps and hand washes, and which use Peracetic acid based laundering processes as an alternative bleaching mechanism.
      Additional study into the efficacy of the United States tunnel washer laundry market on removal/destruction of C.diff spores is warranted as the adherence, removal, and destruction of the spores from synthetic and synthetic-blend cloths have not yet been evaluated.


ARTA thanks Gurtler Industries for supporting the C.diff studies with the expertise and time of Kevin McLaren and Steve Tinker. In addition, we thank Lynne Sehuslter for her comments and review.