The FDA has recommended that medical devices are disinfected after each use, prior to the next patient.23,24 They define high-level disinfection as a process that kills all forms of microbial life (viruses, mycobacteria, fungi, vegetative bacteria) except for large numbers of bacterial spores. This is demonstrated by a 6-log (99.9999%) reduction in specific test organisms after reprocessing the medical device. Trinity Guardion’s laundry process takes this a step further by producing a 99.9999% reduction not only in all the test organisms, but also C. diff spores.22 This provides patients with a truly clean mattress surface. A process that achieves a lower log reduction could put your patients at risk. For example, there are approximately 3.8 million spores in 1 gram of C. diff stool.29 Patients with diarrhea have at least 200g of stool in a 24hr period and up to 15 stooling events in a day.30,31 This could result in hundreds of millions of spores on surfaces within the patient environment. A process that achieves a 5-log reduction in C. diff spores would leave 10x as many spores on a surface as compared to a 6-log reduction. This is troublesome as animal studies have suggested that the infectious dose of C. diff is extremely low,32,33 meaning any spores remaining in the patient ecosystem could put them at risk of infection. Lawley et al. also found that disinfectants that achieve a 6-log reduction of C. diff spores completely eliminated environmental transmission in mice, whereas those with lesser log reductions were not as successful at reducing transmission.
