Bacterial counts of hospital linen and effectiveness of laundry process: A need for consensus on microbial sterility of hospital linen

Background: Health care linen is a source of healthcare-associated infections. Hospital laundry services play a vital role in linen decontamination. Effective laundry is essential in preventing hospital-acquired infections, especially in multidrug-resistant organisms. Aims and Objectives: The study aimed to check the microbial load in linen after the laundry process and the during the supply chain in the hospital. We investigated the bacterial load in linen before and after the laundering process and the linen from stored linen banks. Materials and Methods: Linens (n=125) from the hospital were collected in different stages of the laundry process [31 linen before decontamination; 94 linen after decontamination (Post washing = 30; Linen Bank = 34; Ward 30)]. A square inch of linen from each linen was vortexed in normal saline, and colony forming units (CFU)/inch of linen were calculated using appropriate media. The identification and susceptibility of organisms were performed using MALDI-TOF MS and CLSI disk diffusion methods, respectively. The difference in the load of the organism was analysed between different stages of the laundry and storage process. Results: We found that100% of pre-decontamination linen harbour viable organisms (22.59% including multidrug-resistant pathogenic organisms: MDROs), which decreased to 40% (no MDROs) post-decontamination. The overall load was reduced by a factor of 103.77. Conclusion: The microbial contamination of linen is common, and there is an urgent need to develop consensus on the microbial examination frequency and acceptable range of organisms on hospital linen worldwide.