At a minimum, the FDA recommends mattresses, generally considered a non-critical medical device, undergo low-level disinfection, which is defined as: “A lethal process utilizing an agent that kills vegetative forms of bacteria, some fungi, and lipid viruses.”23 This should be able to achieve a 99.9999% reduction in Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, and representatives of the Klebsiella and Enterobacter genus.24 However, many patients often lie on mattresses with non-intact skin (e.g. port-a-cath, open wounds, dermatitis). Medical devices that make contact with non-intact skin are considered semi-critical medical devices.23 Because linens do not prevent mattresses from contamination25 and the FDA states that devices should be tested to the worst-case scenario, mattresses should be disinfected at least to the level recommended for semi-critical medical devices: high-level disinfection.
Follow-Up: Perform a study on your mattresses to see if they remain contaminated after terminal cleaning. ATP Meters and conventional swabs can underestimate your contamination.26-28 Consider using alternative testing to identify contamination on mattresses.