Lou Portero

Urban Health Today

A new study published in <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0321467">PLOS ONE</a> on April 30, 2025, has revealed concerning findings about the practice of healthcare workers washing their uniforms at home. The research suggests this common practice may be insufficient for proper disinfection and could potentially contribute to the spread of hospital-acquired infections (HAIs) and antimicrobial resistance (AMR).In the UK, more than 80% of nurses launder their uniforms using domestic laundry machines (DLMs). Current guidelines from the National Health Service recommend washing these uniforms at 60&deg;C for 10 minutes to kill almost all bacteria. However, researchers found that many home washing machines fail to reach or maintain this temperature, particularly during quick wash cycles.The study, conducted by researchers Cayrou, Silver, Owen, Dunlop, and Laird from De Montfort University, evaluated six different domestic washing machines and found that<ul class="[&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-disc space-y-1.5 pl-7">
<li class="whitespace-normal break-words">Only 50% of machines achieved sufficient decontamination (&ge;5 log10 CFU reduction) at 60&deg;C during full-length cycles</li>
<li class="whitespace-normal break-words">During rapid wash cycles, 50% of machines failed to reach the stated 60&deg;C temperature, with actual temperatures ranging from 19.72&deg;C to 44.5&deg;C</li>
<li class="whitespace-normal break-words">Most machines could not maintain the peak temperature above 57&deg;C for the recommended 10 minutes</li>
</ul>The researchers also examined the microbiome (bacterial communities) present in 12 domestic washing machines. They found potentially pathogenic bacteria in all machines tested, including species from the Mycobacterium, Pseudomonas, and Acinetobacter genera.Even more concerning was the discovery of antibiotic resistance genes in all machines sampled. The most common resistance mechanisms found were<ol class="[&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-decimal space-y-1.5 pl-7">
<li class="whitespace-normal break-words">Genes encoding efflux pumps (which can pump antibiotics out of bacterial cells)</li>
<li class="whitespace-normal break-words">Genes that alter antibiotic targets</li>
<li class="whitespace-normal break-words">Genes encoding antibiotic inhibitors</li>
</ol>Perhaps the most alarming finding was that exposure to common household detergents could induce antibiotic resistance in bacteria. The researchers tested this assumption by exposing three bacterial species commonly associated with hospital infections (Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa) to increasing concentrations of laundry detergents.The results showed:<ul class="[&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-disc space-y-1.5 pl-7">
<li class="whitespace-normal break-words">S. aureus developed resistance to multiple antibiotics, including penicillin, after exposure to detergents</li>
<li class="whitespace-normal break-words">K. pneumoniae developed resistance to carbapenem antibiotics (often used as a last resort in clinical settings)</li>
<li class="whitespace-normal break-words">Genetic analysis revealed mutations in genes encoding efflux pumps in both S. aureus and K. pneumoniae after detergent exposure</li>
</ul>Lead researcher Dr. Katie Laird commented, &ldquo;Our findings suggest that domestic laundering of healthcare uniforms may be insufficient for decontamination, posing risks for hospital-acquired infection transmission and antimicrobial resistance.&rdquo;Based on these findings, the researchers recommend several changes to current practices:<ol class="[&amp;:not(:last-child)_ul]:pb-1 [&amp;:not(:last-child)_ol]:pb-1 list-decimal space-y-1.5 pl-7">
<li class="whitespace-normal break-words">Regular cleaning of domestic washing machines to reduce biofilm accumulation</li>
<li class="whitespace-normal break-words">Using detergents with proven disinfection efficacy at appropriate concentrations</li>
<li class="whitespace-normal break-words">Providing healthcare workers with approved detergents that have antimicrobial properties</li>
<li class="whitespace-normal break-words">Prioritizing onsite or industrial laundering of healthcare uniforms where temperature and wash parameters can be strictly controlled and monitored</li>
</ol>This research highlights an often-overlooked aspect of infection control in healthcare settings. While considerable attention is given to hand hygiene and surface disinfection, textiles like uniforms can also serve as vectors for pathogen transmission.The study raises important questions about current laundering practices not just for healthcare textiles but potentially for home laundering in general, particularly for households where someone may be immunocompromised or recovering from illness.

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New research reveals domestic washing machines may fail to properly disinfect healthcare textiles, potentially contributing to antibiotic resistance

Home Laundering of Healthcare Uniforms: Potential Risk for Infection Transmission and Antimicrobial 