PMID- 18241730
OWN - NLM
STAT- MEDLINE
DCOM- 20080221
LR  - 20201209
IS  - 1527-3296 (Electronic)
IS  - 0196-6553 (Linking)
VI  - 36
IP  - 1
DP  - 2008 Feb
TI  - Simulated-use testing of bedpan and urinal washer disinfectors: evaluation of 
      Clostridium difficile spore survival and cleaning efficacy.
PG  - 5-11
LID - 10.1016/j.ajic.2007.04.277 [doi]
AB  - BACKGROUND: Reusable bedpans and urinals are frequently cleaned and 
      decontaminated using washer-disinfectors (WDs) that may be located in the central 
      processing department (CPD) or on the ward. The objective of this study was to 
      determine how efficiently the WDs provided cleaning and to evaluate the ability 
      of such WDs to kill Clostridium difficile spores. METHODS: The cleaning efficacy 
      of 2 bedpan/urinal WDs (1 in the ward [ward-WD] and 1 in the CPD [CPD-WD]) were 
      evaluated using simulated-use testing that included an ultraviolet-visible marker 
      (UVM) that is readily removed when exposed to liquid. In addition, a proprietary 
      test object surgical instrument (TOSI) device was used to assess the efficacy of 
      the WDs. Artificial test soil (ATS) and C. difficile spore removal and killing 
      also were evaluated. The removal of approximately 10(6) C. difficile spores and 
      subsequent killing of these spores was assessed using autoclaved stool and/or 
      urine as the soil challenge. RESULTS: Reusable stainless steel bedpans, plastic 
      bedpans, and plastic urinals were assessed. Triplicate testing done on 3 separate 
      days using TOSI devices, UVM, ATS, and stool and urine soils indicated that the 
      ward-WD did not demonstrate adequate cleaning. It was determined that 
      installation errors accounted for the inadequate cleaning. But the ward-WD did 
      not adequately inactivate C. difficile spores even when the installation problems 
      were corrected and the manufacturer-adjusted maximal thermal conditions were 
      used. The CPD-WD was able not only to adequately clean the test devices of 
      organic soil, but also to completely inactivate the 6 logs of C. difficile spores 
      placed in sealed ampules inside the WD. CONCLUSION: The results of this study 
      indicate that user testing of the efficacy of WDs is critical to ensure 
      appropriate functionality. The currently accepted thermal decontamination 
      parameters for all bedpan WDs (ie, 80 degrees C for 1 minute) are not adequate to 
      eliminate C. difficile spores from bedpans.
FAU - Alfa, Michelle J
AU  - Alfa MJ
AD  - Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, 
      Canada. malfa@sbgh.mb.ca
FAU - Olson, Nancy
AU  - Olson N
FAU - Buelow-Smith, Louise
AU  - Buelow-Smith L
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Infect Control
JT  - American journal of infection control
JID - 8004854
RN  - 0 (Disinfectants)
RN  - 0 (Fluorescent Dyes)
SB  - IM
MH  - Clostridioides difficile/*drug effects
MH  - Colony Count, Microbial
MH  - Disinfectants/*pharmacology
MH  - Disinfection/*methods
MH  - Equipment Reuse
MH  - Equipment and Supplies, Hospital/*microbiology
MH  - Fluorescent Dyes/analysis
MH  - Quality Control
MH  - Spores, Bacterial/*drug effects
MH  - Staining and Labeling
EDAT- 2008/02/05 09:00
MHDA- 2008/02/22 09:00
CRDT- 2008/02/05 09:00
PHST- 2005/09/26 00:00 [received]
PHST- 2007/04/15 00:00 [revised]
PHST- 2007/04/17 00:00 [accepted]
PHST- 2008/02/05 09:00 [pubmed]
PHST- 2008/02/22 09:00 [medline]
PHST- 2008/02/05 09:00 [entrez]
AID - S0196-6553(07)00566-4 [pii]
AID - 10.1016/j.ajic.2007.04.277 [doi]
PST - ppublish
SO  - Am J Infect Control. 2008 Feb;36(1):5-11. doi: 10.1016/j.ajic.2007.04.277.